Review of diseases presenting as "midline granuloma". Clinical implications for the appropriate workup of patients with midline granuloma syndrome with emphasis on recent diagnostic advances in lymphoid neoplasms that present as midline destructive lesions.
Midline destructive disorders (so-called 'midline granuloma') comprise a wide variety of diseases that present as destructive lesions in the upper airways. These diverse diseases include infectious, immune and neoplastic disorders, each of which obviously requires a differing therapy. The clinician must have an appreciation of these diseases in order to make a rational approach to diagnosis. Because of recent advances in immunohistochemical techniques, cell typing will necessitate certain changes in the manner in which biopsy material is initially handled. This paper discusses the differential diagnosis of midline destructive disease, the pathologic techniques necessary to diagnose them and recent ideas concerning the pathogenesis of the malignant lymphoid processes which cause some of these diseases.
O'Connor
J C
JC
Department of Pathology, College of Medicine, University of Iowa, Iowa City 52242.
Robinson
R A
RA
D001706:Biopsy; D003937:Diagnosis, Differential; D006103:Granuloma, Lethal Midline / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D010038:Otorhinolaryngologic Diseases / Q000473:pathology*