Granuloma, Lethal Midline
Granuloma
Granuloma, Foreign-Body
Granuloma, Pyogenic
Eosinophilic Granuloma
Granuloma, Respiratory Tract
Midline destructive lesions of the sinonasal tract: simplified terminology based on histopathologic criteria. (1/16)
BACKGROUND AND PURPOSE: Destructive lesions of the sinonasal tract, lacking a discernible etiology and referred to as midline destructive disease, have been pathologically classified in accordance with a variety of confusing terms. Development of new pathologic concepts and immunohistochemical techniques has provided a fresh understanding of these lesions, and, as a result, they can be unified into two distinct pathologic groups: Wegener's granulomatosis and non-Hodgkin's T-cell lymphoma. METHODS: We retrospectively reviewed the imaging studies and pathologic specimens of seven patients with prior diagnoses included in the midline destructive disease group. The specimens were reviewed by an oral pathologist using currently accepted pathologic criteria and the newly available immunohistochemical markers CD20, CD45, and CD45RO. Lesions were classified as non-Hodgkin's T-cell lymphomas when positive for CD45 and CD45RO and negative for CD20, and as Wegener's granulomatosis in the presence of noncaseating multinucleated giant cell granulomas and necrotizing vasculitis. RESULTS: Three of the lesions were reclassified as Wegener's granulomatosis and four as T-cell lymphomas after applying these pathologic criteria. There were no distinguishing imaging findings between Wegener's granulomatosis and non-Hodgkin's T-cell lymphoma. CONCLUSION: The current pathologic classification for midline destructive disease should be incorporated into the radiologic lexicon and the use of terms from the old classification system, such as idiopathic midline granuloma and lethal midline granuloma, should be abandoned and no longer be used in radiologic reports. (+info)Characterization of novel natural killer (NK)-cell and gammadelta T-cell lines established from primary lesions of nasal T/NK-cell lymphomas associated with the Epstein-Barr virus. (2/16)
Studies on nasal T/natural killer (NK)-cell lymphoma have been hampered by its tendency to cause necrosis. Thus, the establishment of cell lines of this neoplasm would seem to be valuable. This study attempted to establish cell lines from primary lesions of this tumor, and successfully obtained 2 novel Epstein-Barr virus (EBV)-positive cell lines, SNK-6 and SNT-8, by means of high-dose recombinant interleukin 2. Flow cytometry showed that SNK-6 had an NK-cell phenotype, CD3- CD4- CD8- CD19- CD56+ T-cell receptor (TCR) alpha/beta- TCR gamma/delta-, whereas SNT-8 was CD3+ CD4- CD8- CD19- CD56+ TCR alpha/beta- TCR gamma/delta+. These were consistent with immunophenotypes of their original tumors, and the cell lines had monoclonal EBV clones identical to ones in their original tumors. Thus, the cell lines developed from cells forming the primary lesions. Genotypic analysis showed that SNK-6 had unrearranged TCR and immunoglobulin heavy-chain genes, supporting the conclusion that SNK-6 was of NK-cell lineage. On the other hand, SNT-8 had rearranged TCR beta-, gamma-, and delta-chain genes, and together with its phenotype, SNT-8 proved to be a gammadelta T-cell line. This is the first report of the establishment of cell lines from primary lesions of nasal T/NK cell lymphomas, and the results demonstrated that there are at least 2 lineages, NK- and gammadelta T-cell, in this neoplasm. Moreover, it has been suggested that nasal T/NK cell lymphomas of these lineages may belong to the same clinicopathologic entity because both types of cases shared common clinical and histopathologic features. (+info)Frequent mutations of Fas gene in nasal NK/T cell lymphoma. (3/16)
Fas (Apo-1/CD95) is a cell-surface receptor involved in cell death signaling through binding of Fas ligand. Mutation of Fas gene in lymphoid cells results in accumulation of these cells, which might thus contribute to lymphomagenesis. We examined the open reading frame of Fas cDNA in 14 cases of nasal NK/T-cell lymphoma. Mutations of Fas gene were detected in seven (50%) of 14 cases which comprised four frameshift, two missense, and one silent mutations. Frameshift mutations were caused by insertion of 1 bp (A) at nucleotide 1095 in two cases and by deletion of 1 bp at nucleotide 597 and at 704, respectively, in one each. Mouse T-cell lymphoma cells transfected with two missense mutated genes and frameshift mutations caused by insertion of 1 bp (A) at nucleotide 1095 were resistant to apoptosis induced by the anti-Fas antibody. These findings suggested that accumulation of lymphoid cells with Fas mutations provides a basis for the development of nasal NK/T-cell lymphoma. (+info)Re-irradiation of a second localization of idiopathic midline destructive disease in the head and neck area. (4/16)
Idiopathic midline destructive disease is a rare disease, characterized by a progressive ulceration and destruction of midline facial structures. We report a case with localization on the palate for which she received radiotherapy. Later she developed a second localization on the posterior pharyngeal wall for which she was re-irradiated, without severe sequels. Twice a complete regression was observed. (+info)Nasal NK/T cell lymphoma presenting as a lethal midline granuloma. (5/16)
Nasal NK/T cell lymphomas are aggressive, locally destructive, midfacial, necrotizing lesions. The nonspecific clinical symptoms constitute a major stumbling block in the early diagnosis and management of these lymphomas. We report here a case of probable nasal NK/T cell lymphoma in an apparently healthy male that progressed rapidly in a short span of time and was managed subsequently with chemotherapy and external beam irradiation with which the lesion regressed. (+info)Functional characterization of antineutrophil cytoplasmic antibodies in patients with cocaine-induced midline destructive lesions. (6/16)
(+info)Brain-derived neurotrophic factor Val/Met polymorphism and bipolar disorder. Association of the Met allele with suicidal behavior of bipolar patients. (7/16)
(+info)Erythematous indurated swelling on nose and upper lip. Cutaneous T cell lymphoma. (8/16)
A 40-year-old man presented for diagnosis with nodules and plaques of the nose and upper lip, progessive over 1(1/2) years. (+info)A lethal midline granuloma (LMG) is a rare and aggressive form of necrotizing granulomatous inflammation that typically involves the nasopharynx, paranasal sinuses, and/or the central nervous system. It is called "lethal" because of its rapid progression and high mortality rate if left untreated.
LMG is a type of granuloma, which is a collection of immune cells that form in response to chronic inflammation or infection. In LMG, the granulomas are characterized by extensive necrosis (tissue death) and vasculitis (inflammation of blood vessels).
The exact cause of LMG is not fully understood, but it is believed to be associated with a variety of factors, including infections (such as fungal or mycobacterial infections), autoimmune disorders, and lymphoproliferative diseases. Treatment typically involves a combination of surgical debridement, antimicrobial therapy, and immunosuppressive drugs. Despite treatment, the prognosis for LMG is generally poor, with a high rate of recurrence and significant morbidity and mortality.
Nose neoplasms refer to abnormal growths or tumors in the nasal cavity or paranasal sinuses. These growths can be benign (non-cancerous) or malignant (cancerous). Benign neoplasms are typically slow-growing and do not spread to other parts of the body, while malignant neoplasms can invade surrounding tissues and have the potential to metastasize.
Nose neoplasms can cause various symptoms such as nasal congestion, nosebleeds, difficulty breathing through the nose, loss of smell, facial pain or numbness, and visual changes if they affect the eye. The diagnosis of nose neoplasms usually involves a combination of physical examination, imaging studies (such as CT or MRI scans), and biopsy to determine the type and extent of the growth. Treatment options depend on the type, size, location, and stage of the neoplasm and may include surgery, radiation therapy, chemotherapy, or a combination of these approaches.
A granuloma is a small, nodular inflammatory lesion that occurs in various tissues in response to chronic infection, foreign body reaction, or autoimmune conditions. Histologically, it is characterized by the presence of epithelioid macrophages, which are specialized immune cells with enlarged nuclei and abundant cytoplasm, often arranged in a palisading pattern around a central area containing necrotic debris, microorganisms, or foreign material.
Granulomas can be found in various medical conditions such as tuberculosis, sarcoidosis, fungal infections, and certain autoimmune disorders like Crohn's disease. The formation of granulomas is a complex process involving both innate and adaptive immune responses, which aim to contain and eliminate the offending agent while minimizing tissue damage.
A granuloma is a type of organized immune response that occurs when the body encounters a foreign substance that it cannot eliminate. A "foreign-body" granuloma specifically refers to this reaction in response to an exogenous material, such as a splinter, suture, or other types of medical implants.
Foreign-body granulomas are characterized by the formation of a collection of immune cells, including macrophages and lymphocytes, which surround and attempt to isolate the foreign material. Over time, this collection of immune cells can become walled off and form a well-circumscribed mass or nodule.
Foreign-body granulomas may cause localized symptoms such as pain, swelling, or inflammation, depending on their location and size. In some cases, they may also lead to complications such as infection or tissue damage. Treatment typically involves removing the foreign body, if possible, followed by anti-inflammatory therapy to manage any residual symptoms or complications.
A pyogenic granuloma is not precisely a "granuloma" in the strict medical definition, which refers to a specific type of tissue reaction characterized by chronic inflammation and the formation of granulation tissue. Instead, a pyogenic granuloma is a benign vascular tumor that occurs most frequently on the skin or mucous membranes.
Pyogenic granulomas are typically characterized by their rapid growth, bright red to dark red color, and friable texture. They can bleed easily, especially when traumatized. Histologically, they consist of a mass of small blood vessels, surrounded by loose connective tissue and inflammatory cells.
The term "pyogenic" is somewhat misleading because these lesions are not actually associated with pus or infection, although they can become secondarily infected. The name may have originated from the initial mistaken belief that these lesions were caused by a bacterial infection.
Pyogenic granulomas can occur at any age but are most common in children and young adults. They can be caused by minor trauma, hormonal changes, or underlying medical conditions such as pregnancy or vasculitis. Treatment typically involves surgical excision, although other options such as laser surgery or cauterization may also be used.
Eosinophilic granuloma is a term used in pathology to describe a specific type of inflammatory lesion that is characterized by the accumulation of eosinophils, a type of white blood cell, and the formation of granulomas. A granuloma is a small nodular structure formed by the accumulation of immune cells, typically including macrophages, lymphocytes, and other inflammatory cells.
Eosinophilic granulomas can occur in various organs of the body, but they are most commonly found in the lungs, skin, and bones. In the lungs, eosinophilic granulomas are often associated with hypersensitivity reactions to inhaled antigens, such as dust mites or fungal spores. They can also be seen in association with certain diseases, such as Langerhans cell histiocytosis, an uncommon disorder characterized by the abnormal proliferation of a type of immune cell called Langerhans cells.
The symptoms of eosinophilic granuloma depend on the location and extent of the lesion. In the lungs, eosinophilic granulomas may cause cough, chest pain, or shortness of breath. In the skin, they may present as nodules, plaques, or ulcers. In the bones, they can cause pain, swelling, and fractures.
The diagnosis of eosinophilic granuloma is typically made based on a combination of clinical, radiological, and pathological findings. Treatment may include avoidance of known antigens, corticosteroids, or other immunosuppressive medications, depending on the severity and location of the lesion.
A granuloma in the respiratory tract refers to a small nodular lesion that forms in the lung tissue due to an ongoing immune response. It is typically composed of macrophages, lymphocytes, and other inflammatory cells that cluster together around a foreign substance or organism that the body cannot eliminate.
Granulomas can form in response to various stimuli, including infectious agents such as mycobacteria (tuberculosis, nontuberculous mycobacteria), fungi, and parasites, as well as non-infectious causes like inhaled particles (e.g., silica, beryllium) or autoimmune diseases (e.g., sarcoidosis).
These lesions can cause damage to the lung tissue over time, leading to symptoms such as cough, shortness of breath, chest pain, and fatigue. Diagnosis often involves imaging studies like chest X-rays or CT scans, followed by biopsy and microscopic examination to confirm the presence of granulomas and identify the underlying cause. Treatment depends on the underlying cause but may include antibiotics, corticosteroids, or other immunosuppressive medications.
Granuloma annulare is a chronic, inflammatory skin condition characterized by the formation of small, red or flesh-colored bumps that form rings or arcs. These lesions are usually found on the hands and feet but can occur anywhere on the body. The exact cause of granuloma annulare is unknown, but it may be associated with triggers such as insect bites, viral infections, sun exposure, or certain medications.
Histologically, granuloma annulare is characterized by a specific type of inflammatory cell infiltrate, consisting of histiocytes (a type of white blood cell) arranged in palisades around the edges of small collections of mucin (a glycoprotein). This distinctive pattern helps to differentiate granuloma annulare from other skin conditions.
Granuloma annulare is generally a benign condition that does not cause any symptoms or complications, although some people may experience itching or discomfort in the affected areas. In most cases, the lesions will resolve on their own within a few months to two years, although they can recur in some individuals. Treatment options for granuloma annulare include topical corticosteroids, phototherapy, and intralesional steroid injections, although observation is also a reasonable approach in many cases.
Lethal midline granuloma
Granulomatosis with polyangiitis
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Indolent T cell lymphoproliferative disorder of the gastrointestinal tract
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Lethal midline granuloma - Wikipedia
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Granulomatosis with polyangiitis2
- Subsequent studies found that the cells infiltrating the midline tissues in cases of lethal midline granuloma that were not clearly diagnosed as granulomatosis with polyangiitis were: a) infected by the Epstein-Barr virus and b) consisted of malignant lymphocytes, usually NK cells or, rarely, cytotoxic T cells. (wikipedia.org)
- Since cases of LMG that were manifestations of granulomatosis with polyangiitis, a vascular inflammatory but not malignant disease, the term lethal midline granuloma is considered confusing and obsolete. (wikipedia.org)
Facial2
- Patients presenting with highly localized midline facial disease fit the historical definition of lethal midline granuloma. (wikipedia.org)
- A condition that is characterized by inflammation, ulceration, and perforation of the nose and the PALATE with progressive destruction of midline facial structures. (nih.gov)
Term2
- Lethal midline granuloma (LMG) is an historical term for a condition in which necrotic and highly destructive lesions develop progressively in the middle of the face, principally the nose and palate. (wikipedia.org)
- The term was used as a synonym for lethal midline granuloma. (nih.gov)
Malignant5
- Subsequent studies found that the cells infiltrating the midline tissues in cases of lethal midline granuloma that were not clearly diagnosed as granulomatosis with polyangiitis were: a) infected by the Epstein-Barr virus and b) consisted of malignant lymphocytes, usually NK cells or, rarely, cytotoxic T cells. (wikipedia.org)
- Since cases of LMG that were manifestations of granulomatosis with polyangiitis, a vascular inflammatory but not malignant disease, the term lethal midline granuloma is considered confusing and obsolete. (wikipedia.org)
- Biopsy findings in malignant histiocytosis presenting as lethal midline granuloma. (bmj.com)
- Nasal biopsy findings in malignant histiocytosis presenting clinically as lethal midline granuloma are characterised by necrosis and infiltration of atypical histiocytic cells with a diffuse positive reaction for non-specific esterase. (bmj.com)
- This cellular character was common to midline malignant reticulosis, and midline malignant reticulosis and malignant histiocytosis are thought to be the same disease. (bmj.com)
Lymphoma1
- 19. Extranodal natural killer/T-cell lymphoma, nasal type: 'midline lethal granuloma. (nih.gov)
Lesions2
- Lethal midline granuloma (LMG) is an historical term for a condition in which necrotic and highly destructive lesions develop progressively in the middle of the face, principally the nose and palate. (wikipedia.org)
- Destructive midline facial lesions have conventionally been referred to as lethal midline granuloma. (openpr.com)
Synonym1
- The term was used as a synonym for lethal midline granuloma. (nih.gov)