title: [Differential diagnostic aspects of lethal midline granulomas (granuloma gangraenescens].
abstract: The lethal midline granuloma and limited Wegener's granulomatosis show clinical similarity, although they are of different etiology. The following case of a 53-year-old woman shows how difficult it is to establish the precise diagnosis of lethal midline granuloma. The diagnosis depends on the pathological finding of a lymphoma. The lymphoma can be differentiated in a T- or a B-cell lymphoma by immunostaining. However, the diagnostic yield of biopsies from the nose is not perfect. It would be, therefore, important to find other diagnostic criteria. The presence of the c-ANCA is a helpful tool, but in the case of limited Wegener's granulomatosis, it has a sensitivity of 50%. The prognosis of the lethal midline granuloma is poor even if an adequate radiation therapy is instituted.
authors.affiliation: Abteilung Rheumatologie, Medizinische Universitätsklinik Freiburg.
authors.forename: U M
authors.initials: UM
authors.lastname: Rothacher
authors.forename: J A
authors.initials: JA
authors.lastname: Rump
authors.forename: E W
authors.initials: EW
authors.lastname: Herbst
authors.forename: U
authors.initials: U
authors.lastname: Blum
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.forename: H H
authors.initials: HH
authors.lastname: Peter
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006103:Granuloma, Lethal Midline / Q000175:diagnosis*; D006801:Humans; D007150:Immunohistochemistry; D016130:Immunophenotyping; D008875:Middle Aged; D014057:Tomography, X-Ray Computed
vernacular_title: Differentialdiagnostische Aspekte des letalen Midline-Granuloms (Granuloma gangraenescens).