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Clinical Problem Solving: Pathology
October 2003

Pathology Quiz Case—Diagnosis

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2003;129(10):1136. doi:10.1001/archotol.129.10.1135

Clinical manifestations of nasal T/NK-cell lymphomas may simulate those of other disease entities, and inadequate nasal biopsies may lead to nonspecific histopathologic pictures; therefore, early diagnosis of these lymphomas is a real challenge for both otolaryngologists and pathologists. Nasal T/NK-cell lymphomas usually present as extremely destructive lesions over the nasal cavities, paranasal sinuses, or nasopharynx, showing a necrotic and angioinvasive histopathologic pattern. In the past, they were included under the nebulous and descriptive term lethal midline granuloma.1 With the advance of immunohistochemical analysis and a growing understanding of sinonasal lymphomas, nasal T/NK-cell lymphomas could be distinguished from other groups of lethal midline granulomas, including infectious (such as tuberculosis) and noninfectious (such as WG) lesions.2

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