Abstract

At present lethal midline granuloma falls into 3 distinct and separate clinicopathological entities: (a) malignant lymphoma, (b) midline malignant reticulosis, and (c) Wegener’s granulomatosis. Lethal midline granuloma (LMG) is included in the conditions with ulceration and rapid destruction of upper respiratory tract. Destructive and ulcerative lesions in the upper respiratory tract are frequently met with clinicians and also pathologists, by which diagnostic and therapeutic difficulties may be occasionally followed. For these reasons, this study is aimed to confirm the previous diagnosis, classify the 3 entities, and evaluate the diagnostic problems in inadequate biopsy materials and also evaluate the ulcerative non-specific lesions by repent and/or follow-up biopsies. This study consists of 35 cases of lethal midline granuloma for 10 years period lasting from 1968 to 1977, among them 21 cases being malignant lymphoma and 14 cases midline malignant reticulosis. The differentiation between these 3 entities is emphasized. Lethal midline granuloma should be used only as a clinical term, and early and definite diagnosis is important for these lesions by means of repeated adequate biopsies.