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Polymorphic reticulosis (lethal midline granuloma) and lymphomatoid granulomatosis: Identical or distinct entities?

Summary

Two cases of polymorphic reticulosis were studied. Both cases had a fatal clinical course, that of the second case being rapid and progressive and ending 6 months after the onset of the disease with little demonstrable effect of steroid therapy. Biopsy material was obtained in both patients, and both were submitted to a post-mortem examination. The first case showed typical angiocentric, angiodestructive, polymorphous lymphoreticular infiltrates, involving the pharyngeal region and the tongue. The second case demonstrated these same lesions in the midfacial region, the lungs and the skin. A possible identity between polymorphic reticulosis and lymphomatoid granulomatosis is discussed (because of the coexistance of identical lesions in the midfacial region and in the lung parenchyma in the second case). Wegener's granulomatosis in limited and disseminated forms and malignant lymphoma are considered in the differential diagnosis.

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References

  1. Allison GR, Rappaport I (1976) Lethal midline granuloma. Plast Reconstr Surg 58:434–439

    Google Scholar 

  2. Anderson JM, Jamieson DG, Jefferson JM (1975) Non-healing granuloma and the nervous system. Q J Med 174:309–323

    Google Scholar 

  3. Chen KTK (1977) Abdominal form of lymphomatoid granulomatosis. Hum Pathol 8:99–103

    Google Scholar 

  4. Crissman JD (1979) Midline malignant reticulosis and lymphomatoid granulomatosis. Arch Pathol Lab Med 103:561–564

    Google Scholar 

  5. Damjanov I, Durakovic Z, Radonic M (1975) Lymphomatoid granulomatosis of the lung associated with active tuberculosis. Z Erkr Atmungsorgane 143:56–60

    Google Scholar 

  6. DeRemee RA, Weiland LH, McDonald TJ (1978) Polymorphic reticulosis, lymphomatoid granulomatosis. Two diseases or one? Mayo Clin Proc 53:634–640

    Google Scholar 

  7. Douglas AC, Anderson TJ, MacDonald M (1976) Midline and Wegener's granulomatosis. Ann NY Acad Sci 278:618–635

    Google Scholar 

  8. Eichel BS, Mabery TE (1968) The enigma of the lethal midline granuloma. Laryngoscope 78:1367–1386

    Google Scholar 

  9. Fauci AS, Johnson RE, Wolff SM (1978) Midline granuloma or Wegener's granulomatosis. Ann Intern Med 84:609–610

    Google Scholar 

  10. Friedman I, Sando I, Balkany T (1978) Idiopathic pleomorphic midfacial granuloma (Stewart's type). J Laryngol Otol 92:601–611

    Google Scholar 

  11. Fu YS, Perzin KH (1979) Nonepithelial tumors of the nasal cavity, paranasal sinuses and nasopharynx. A clinicopathologic study. X. Malignant lymphomas. Cancer 43:611–621

    Google Scholar 

  12. Gibbs AR (1977) Lymphomatoid granulomatosis — a condition with affinities to Wegener's granulomatosis and lymphoma. Thorax 32:71–79

    Google Scholar 

  13. Kassel SH, Echevarria RA, Guzzo FP (1969) Midline malignant reticulosis (so-called lethal midline granuloma). Cancer 23:920–935

    Google Scholar 

  14. Katzenstein ALA, Carrington CB, Liebow AA (1979) Lymphomatoid granulomatosis. A clinicopathologic study of 152 cases. Cancer 43:360–373

    Google Scholar 

  15. Kay S, Fu YS, Minars N, Brady JW (1974) Lymphomatoid granulomatosis of the skin: light microscopic and ultrastructural studies. Cancer 34:1675–1682

    Google Scholar 

  16. Lee SC, Roth LM, Brashear RE (1976) Lymphomatoid granulomatosis. A clinicopathologic study of four cases. Cancer 38:846–853

    Google Scholar 

  17. Liebow AA, Carrington CRB, Friedman PJ (1972) Lymphomatoid granulomatosis. Hum Pathol 3:457–558

    Google Scholar 

  18. Liebow AA (1973) Pulmonary angiitis and granulomatosis. Am Rev Respir Dis 108:1–18

    Google Scholar 

  19. McDonald TJ, DeRemee RA, Harrison EG Jr, Facer GW, Devine KO (1976) The protean clinical features of polymorphic reticulosis (lethal midline granuloma). Laryngoscope 86:936–945

    Google Scholar 

  20. McGuirt WF, Rose EF (1976) Lethal midline granuloma: a pathological spectrum. J Laryngol Otol 90:459–466

    Google Scholar 

  21. MacKinnon DM (1970) Lethal midline granuloma of the face and larynx. J Laryngol Otol 84:1193–1203

    Google Scholar 

  22. Michaels L, Gregory MM (1977) Pathology of “non-healing (midline) granuloma”. J Clin Pathol 30:317–327

    Google Scholar 

  23. Pena CE (1977) Lymphomatoid granulomatosis with central involvement. Light and electron microscopic study of a case. Acta Neuropathol 37:193–197

    Google Scholar 

  24. Saldana MJ, Patchefsky AS, Israel HI, Atkinson GW (1977) Pulmonary angiitis and granulomatosis. The relationship between histological features, organ involvement, and response to treatment. Hum Pathol 8:391–409

    Google Scholar 

  25. Stewart JP (1933) Progressive lethal granulomatous ulceration of the nose. J Laryngol 48:657–701

    Google Scholar 

  26. Weisbrodt IM (1976) Lymphomatoid granulomatosis of the lung, associated with a long history of benign lymphoepithelial lesions of the salivary glands and lymphoid interstitial pneumonitis. Report of a case. Am J Clin Pathol 66:792–801

    Google Scholar 

  27. Yockey CC (1977) Lymphomatoid granulomatosis presenting as a fever of unknown origin. JAMA 237:2633–2634

    Google Scholar 

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Correspondence to Yusuf Kapanci.

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Stamenkovic, I., Toccanier, M.F. & Kapanci, Y. Polymorphic reticulosis (lethal midline granuloma) and lymphomatoid granulomatosis: Identical or distinct entities?. Virchows Arch. A Path. Anat. and Histol. 390, 81–91 (1981). https://doi.org/10.1007/BF00443899

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Key words

  • Midfacial
  • Lung
  • Lethal granuloma
  • Lymphomatoid granulomatosis
  • Reticulosis