No abstract available.
Granuloma, Lethal Midline*

No abstract available.
Granuloma, Lethal Midline*

Diagnosis, Differential ; Granuloma, Lethal Midline ; diagnosis ; therapy ; Humans ; Infant ; Male

Five cases of histologically proven polymorphic reticulosis were examined with computed tomography(CT). CT findings were mucosal thickening along the septal and lateral walls of the nasal cavities(n=4), obliteration of the contour of the nasopharynx(n=4), involvement of the paranasal sinuses (n=2), destruction of the nasal septum and/or sinus walls(n=3) and mass in the palate, tonsil or neck (n=1). CT examination was helpful in determining the extent of the disease in the nasal cavity and paranasal sinuses. However, lesions in the palate and tonsils could not be easily evaluated with CT. CT findings of polymorphic reticulosis are nonspecific and granulomatous diseases may show similar CT findings.
Granuloma, Lethal Midline* ; Nasal Cavity ; Nasal Septum ; Neck ; Palate ; Palatine Tonsil ; Paranasal Sinuses

BACKGROUND AND OBJECTIVES: The histologic features of polymorphic reticulosis are identical to those of sinonasal "angiocentric immunoproliferative lesions" (AILs) which are characterized by angiocentric and angioinvasive lymphoid infiltrates with a wide range of cytologic atypia. 1) This report was conducted to further define the clinicopathological nature of this lesion and evaluate the important prognostic factors and therapeutic strategies. MATERIALS AND METHODS: The clinical features and therapeutic outcomes of 22 patients with AILs were reviewed. Histologic grading was performed by using previously reported criteria (Grade I-III).2) To clarify the cell origin of AIL, immunohistochemical studies were performed in 21 cases. RESULTS: On the slide review, 10 cases were Grade II and 12 cases were grade III which showed characteristic histologic features similar to those of peripheral T-cell lymphoma. On immunohistochemical studies, neoplastic cells of all patients had a T-cell phenotype. The difference in primary treatment results according to the histologic grade, clinical staging and therapeutic modalities was not significant statistically. The overall 5 year survival rates were 58%. CONCLUSION: Our results suggest strongly that quite a significant portion of AIL may be in fact T-cell lymphoma. The only significant prognostic factor that predicts better survival is the achievement of initial complete response.
Granuloma, Lethal Midline ; Head* ; Humans ; Lymphoma, T-Cell ; Lymphoma, T-Cell, Peripheral ; Neck* ; Phenotype ; Survival Rate ; T-Lymphocytes

Mature T-cell and natural killer-cell neoplasms account for 10 to 15% of all non-Hodgkin's lymphomas. Of the various subtypes of mature T-cell and NK-cell lymphomas, extranodal NK/T-cell lymphoma, nasal type (nasal type NK/T-L) is relatively more common among Asians including Koreans. Nasal type NK/T-L is an aggressive, Epstein-Barr virus-associated lymphoma with characteristic expression of NK-cell antigen CD56. In this report, we present an unusual case of EBV(+), CD56(-) NK/T-L of oropharynx which recurred in duodenum after the period of complete remission lasting for 10 years. A 58-year-old woman presented with 3 months history of abdominal pain. Gastroduodenoscopy showed the diffuse wall thickening with multiple ulcerations in bulb and proximal second portion of the duodenum. Pathological examination revealed the infiltration of atypical lymphocytes, which was positive for CD3, CD4, CD5, TIA-1, and EBV and was negative for CD15, CD20, and CD56, consistent with NK/T-L of mature T-cell origin. The past medical history included the presence of oropharyngeal mass 10 years earlier, which was diagnosed as polymorphic reticulosis. The mass resolved completely after the radiation therapy, and she remained free of the disease for 10 years. Upon review, the oropharyngeal biopsy showed an identical morphology and immunophenotype with duodenal lesion. In conclusion, we experienced an unusal case of NK/T-cell lymphoma, nasal type recured in the duodenum.
Abdominal Pain ; Asian Continental Ancestry Group ; Biopsy ; Duodenum ; Female ; Granuloma, Lethal Midline ; Herpesvirus 4, Human ; Humans ; Lymphocytes ; Lymphoma* ; Lymphoma, Non-Hodgkin ; Middle Aged ; Oropharynx ; Recurrence* ; T-Lymphocytes ; Ulcer

From 1979 to 1987, 33 patients with polymorphic retrculosis (PMR) limited in the upper airway were treated with primary radiation therapy and the analysis of treatment results was undertaken. Systemic symptoms such as fever, night sweats, and weight loss were noted in 48%. The nasal cavity was most frequently involved (85%), although involvement of PNS (33%) and palate (30%) was not uncommon. The 5 and 10 year actuarial survival rates were 47% and 40%, respectively. The difference in NSD between patients with in-field failure and those without it was significant statistically. Also, field size was significantly smaller in patients with marginal failure than those without it. During the follow-up period, systemic failure was found in 5 patients (diffuse histiocytic lymphoma in 4, histiocytic medullary retriculosis in 1). In this study, we can suggested that total radiation dose of at least 4500 cGy with generous treatment volume should be delivered to achieve better local control and that the development of an effective systemic chemotherapeutic regimen is required to improve the survival after systemic relapse.
Fever ; Follow-Up Studies ; Granuloma, Lethal Midline ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Nasal Cavity ; Palate ; Radiotherapy ; Recurrence ; Survival Rate ; Sweat ; Weight Loss

BACKGROUND AND OBJECTIVES: Polymorphic reticulosis (PMR), a type of lethal midline granuloma, has characteristics of necrosis, angiocentricity, and angiogenesis, which is also known as nasal T-cell lymphoma. In this study, we classified PMR and nasal lymphoma using immunohistochemical staining and investigated the clinical characteristics of nasal malignant lymphoma including survival rates with treatment modalities. MATERIALS AND METHODS: Twenty-six patients previously diagnosed with PMR or nasal lymphoma from May 1992 to April 1997 were included in this study. We performed immunohistochemical staining with CD3, CD56 and CD79a for classification and reviewed the patients' clinical characteristics and survival rates, retrospectively. RESULTS: Of twenty-six patients, twenty-five patients were classified as having angiocentric lymphoma and only one patient with B-cell lymphoma. Higher mortality rates were observed in patients receiving chemotherapy alone than in those receiving chemotherapy and radiation therapy and in advanced stage. CONCLUSIONS: Early detection and combined treatment could improve the survival rate of patients with nasal malignant lymphomas.
Classification* ; Drug Therapy ; Granuloma, Lethal Midline ; Humans ; Lymphoma* ; Lymphoma, B-Cell ; Lymphoma, T-Cell ; Mortality ; Necrosis ; Nose ; Retrospective Studies ; Survival Rate

Primary nasal type natural killer (NK)/T cell (NKTC) lymphoma, a specific form of malignant lymphoma, has a higher geographic incidence in Oriental, Mexican, and South American populations than the Western population. In Koreans, it comprises 9-12% of all cases of non-Hodgkin's lymphoma. This type of lymphoma has also been named as angiocentic lymphoma and lethal midline granuloma because the most common site is the upper airway area and its clinical aggressiveness presents with a necrotic and destructive pattern. NKTC lymphoma can also be detected in different organs (testis, spleen, parotid gland, skin, gastroinstinal tract, central nervous system, lungs, bone marrow, etc.) other than the upper airway including the oral cavity. The lymphoma detected in the oral cavity shows various destructive and inflammatory changes, similar to the signs of inflammation and infection from periodontitis and pulpal disease, making a diagnosis difficult with just the clinical signs. For early detection, clinical, radiological, and pathological examinations are required. This report describes the clinical, radiological and histological characteristics with a case report for the early detection of NKTC lymphoma in the oral cavity.
Bone Marrow ; Central Nervous System ; Early Diagnosis ; Granuloma, Lethal Midline ; Incidence ; Inflammation ; Lung ; Lymphoma ; Lymphoma, Non-Hodgkin ; Mouth ; Parotid Gland ; Periodontitis ; Skin ; Spleen

Natural killer (NK)/T cell lymphoma is a lethal midline granuloma that produces necrotic and granulomatous lesions in the upper respiratory tract, especially in the nasal cavity. This tumor affects the nose and midface, but can also arise in the skin, gastrointestinal tract, testes, central nervous system, lungs, salivary glands, bone marrow, and larynx. Five to eight percent of extranodal lymphomas involve the orbit, and 1.3~2.0% of these present as primary orbital tumors. The skin can also be the primary site of NK/T cell lymphomas. Aside from affecting the nasal and facial skin, the tumor can involve the skin of the postauricular area, back, trunk, and upper and lower extremities. We present the case of a 37-year-old woman who had a nasal NK/T cell lymphoma with cutaneous and ocular involvement.
Adult ; Bone Marrow ; Central Nervous System ; Female ; Gastrointestinal Tract ; Granuloma, Lethal Midline ; Humans ; Larynx ; Lower Extremity ; Lung ; Lymphoma ; Nasal Cavity ; Nose ; Orbit ; Respiratory System ; Salivary Glands ; Skin ; Testis