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midline granuloma (facial granuloma)
Chronic inflammatory disease characterized by thrombosis of small blood vessels & focal necrosis leading to destruction of the nasal septum, palate, paranasal sinuses & midline facial structures.
Etiology: angiocentric T-cell lymphoma
Epidemiology: more frequent in women
Clinical manifestations:
1) initial manifestations
- rhinorrhea
- nasal congestion & pain
- paranasal sinusitis
2) advanced manifestations:
a) inflammation & ulceration of nasal septum & palate
b) perforation & destruction of midline facial structures
- pharynx
- eyes
- sinuses
- mouth
c) death from:
- cachexia
- pneumonia
- meningitis
- hemorrhage
Laboratory:
1) complete blood count (CBC): leukocytosis
2) skin biopsy
Related
angiocentric T-cell lymphoma (lymphomatoid granulomatosis, polymorphic reticulosis, midline malignant reticulocytosis, Stewart's granuloma)
General
granulomatous disease
thrombophlebitis (includes superficial venous thrombosis)
References
- DeGowin & DeGowin's Diagnostic Examination, 6th edition,
RL DeGowin (ed), McGraw Hill, NY 1994, pg 890
- Color Atlas & Synopsis of Clinical Dermatology, Common
& Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY,
1997, pg 554