1/57. Curative treatment of malignant midline granuloma of the face.The symptomatology of the malignant centro-facial granuloma is described. A case and its treatment are demonstrated. radiotherapy achieved complete healing. The possibilities of treatment are discussed and the author expresses the opinion that radiotherapy is the method of choice for treating centro-facial malignant granuloma.- - - - - - - - - - ranking = 1keywords = granuloma (Clic here for more details about this article) |
2/57. Lethal midline granuloma starting as granuloma laryngis.We report a case of lethal midline granuloma in a 34-year-old male patient. The patient was referred to our hospital because of long-lasting hoarseness. He was treated for granuloma laryngis. After two years nasal obstruction developed followed by ulceration of the hard palate and destruction of part of the nose and the upper lip. A biopsy demonstrated polymorphic infiltrate consisting of small lymphocytes, plasma cells, macrophages, atypical lymphoid cells and eosinophils. radiotherapy was very effective and led to long-term remission. The different etiological aspects of this syndrome are discussed.- - - - - - - - - - ranking = 1.6666666666667keywords = granuloma (Clic here for more details about this article) |
3/57. Lethal midline granuloma: report of three cases.Lethal midline granuloma (LMG) is a rare clinical entity characterized by progressive relentless ulcerations and necrosis of midfacial structures. It occurs more frequently in Oriental than in Western populations with no demonstrable etiology. Treatment and outcome for cases differ, but their pathological distinction may not always be possible from routine biopsy specimens. The histological features often seen include widespread coagulative necrosis, heavy inflammatory infiltrates, and atypical pleomorphic cells. However, the paucity of these atypical cells in biopsy specimens and the degree of necrosis can make the diagnosis of a neoplastic lesion very difficult. Because of the progress in pathology methodology including immunohistochemistry, most cases have been proven to be malignant lymphomas of T-cell lineage. We present 3 patients for whom an initial clinical diagnosis of LMG was made. From their several oral biopsies and nasal specimens, difficulties were encountered in differentiating "midline granuloma" from other possible diseases using histomorphological criteria alone. After extensive evaluations, malignant T-cell lymphoma was the specific disease entity identified in only one case by cell membrane immunostaining technique. A literature review was carried out, and recent concepts of the etiology and pathogenesis of this disease are presented.- - - - - - - - - - ranking = 1keywords = granuloma (Clic here for more details about this article) |
4/57. Midfacial granuloma syndrome or an inflammatory non-specific disease? A case report.We report a case of idiopathic midline destructive disease in a 57-year-old man. The patient had a non-specific histological pattern in biopsies obtained from the nose and upper lip, characterized by a granulomatous reaction with progressive destruction of the tissues. The patient's general medical history was non-contributory. Clinical and laboratory data did not support any feasible etiology for this destructive process. The patient was treated with prednisone until the discovery of type II diabetes mellitus (never diagnosed before) and was then in turn treated only with oral antidiabetic therapy. Follow-up controls revealed progressive reduction of the symptoms and of the nasal and lip lesions and total remission of symptoms up to 2 years after the onset of the disease. We discuss the diagnostic and subsequent therapeutic problems in the management of the midline necrotizing lesions.- - - - - - - - - - ranking = 0.83333333333333keywords = granuloma (Clic here for more details about this article) |
5/57. skull base granuloma: an unusual location of idiopathic midline destructive disease.A rare case of idiopathic midline destructive disease is presented, which is an entity of the so-called midline granuloma syndrome. Differentiation from other granulomas, especially from Wegener's granulomatosis, is important. This report shows the MR findings in a patient with atypical clinical presentation of histopathologically proven idiopathic midline destructive disease.- - - - - - - - - - ranking = 1.1666666666667keywords = granuloma (Clic here for more details about this article) |
6/57. Imported mucocutaneous leishmaniasis in new york city. Report of a patient treated with amphotericin b.A case of mococutaneous leishmaniasis in a patient referred to Memorial Sloan-Kettering Cancer Center, New York, with a presumptive diagnosis of lethal mid-line granuloma is described. The patient had lived in bolivia and had been treated with antimony during and after which his mucosal lesions progressed. These lesions completely healed with 971 mg of amphotericin b. Mucocutaneous leishmaniasis is endemic in many areas of Central and south america and may occur in patients in the united states who have lived in or traveled to these areas. Organisms may be difficult to identify, and multiple biopsies and cultures may be necessary. The use of amphotericin b for the treatment of leishmaniasis is reviewed. It is an effective alternative to antimony therapy, and in some cases resistant to antimony, it may be the drug of choice.- - - - - - - - - - ranking = 0.16666666666667keywords = granuloma (Clic here for more details about this article) |
7/57. Differential diagnosis of midline facial granulomas.The list of differential diagnoses in the case of midline facial granulomatous lesions is long. Intensive investigation into the true origin of disease must be done before definitive treatment can be begun. Extensive and repeated biopsies are necessary. The diagnosis may narrow down to the nonspecific midline lethal granuloma. Evidence in the literature coupled with our experience strongly indicates that this disease does not exist as a pathologic entity but merely as a clinical syndrome which upon further evaluation will reveal either Wegener's granulomatosis or a reticulum cell neoplasm. Treatment of the syndrome consists of corticosteroid drugs, irradiation, and chemotherapy until a definitive diagnosis is made. Midline granulomas have been and will continue to be a challenging diagnostic and therapeutic problem for the otolaryngologist.- - - - - - - - - - ranking = 1.3333333333333keywords = granuloma (Clic here for more details about this article) |
8/57. Immunological features and corticosteroid therapy of midline granuloma.This paper presents treatment of midline granuloma with corticosteroids and immunological features of this disease. The cellular immunity state of this patient was examined by counting T cell subpopulation and lymphocyte blastformation index (BI) by phytohemagglutinin at various time intervals during the corticosteroid therapy. Consequently, the percentage of T cells and BI became greatly increased according to the subsiding of the primary lesion, whereas non-T cell production and its function were depressed. In this communication we discuss a possible autoantibody mechanism and impared lymphocyte transformation in midline granuloma.- - - - - - - - - - ranking = 1keywords = granuloma (Clic here for more details about this article) |
9/57. Centrofacial malignant T-cell lymphoma exhibiting recurrent fever and skin ulcer in a 3-year-old girl.A rare case of undetermined fever and skin ulcers is reported. The patient had an 8-month history of recurrent fever, destructive ulceration of the midline facial tissue, and symmetrical skin ulcer in the cheeks and the back of the hand. Pathological examination revealed that the patient had lethal midline granuloma (centrofacial malignant T-cell lymphoma), which is very rare in childhood. Centrofacial malignant T-cell lymphoma should be considered as a differential diagnosis of unexplained fever and skin ulcer in children.- - - - - - - - - - ranking = 0.16666666666667keywords = granuloma (Clic here for more details about this article) |
10/57. Lethal midline granuloma (peripheral T-cell lymphoma) after lymphomatoid papulosis.A Japanese woman with an 8-year history of lymphomatoid papulosis (LP) had lethal midline granuloma (LMG) develop at the age of 51 years. There were histologic similarities between LP and LMG seen in this patient. Surface phenotypic studies on nasal and cutaneous lesions demonstrated a population of T-cells expressing CD2, CD4, CD25, CD30, and histocompatibility antigen-DR (HLA-DR). Genotypic analyses of nasal and skin biopsy specimens disclosed a clonal rearrangement of the beta T-cell receptor gene with the same rearrangement pattern. These data indicate that this patient had LMG characterized by clonal peripheral T-cell lymphoma, which probably resulted from progression of the LP.- - - - - - - - - - ranking = 0.83333333333333keywords = granuloma (Clic here for more details about this article) |
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