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January 1959

Lethal Midline Granuloma of the FaceReport of Case and Review of the Literature

AMA Arch Intern Med. 1959;103(1):116-122. doi:10.1001/archinte.1959.00270010122016

Introduction  Lethal midline granuloma was first described by McBride,1 in 1897 and is rare. It occurs rarely below the age of 20 and is almost nonexistent in females, with the sex ratio being reported by Woodburn and Harris2 as 20:1.Although the clinical course is typical, the diagnosis of lethal midline granuloma can be made only by exclusion. Approximately 100 cases have been reported in the literature. Only 50% of these were autopsied, and many did not have histologic examination of all organs and complete laboratory studies.The diagnosis is frequently confused with syphilis, tuberculosis, neoplasms, and fungus diseases.

Report of Case  A 35-year-old white male postal clerk was admitted to the Philadelphia Veterans' Administration Hospital on Feb. 7, 1957, with a large ulcerated lesion involving the left side of the nose and a large part of the left cheek, associated with marked edema of surrounding areas.The

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