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(30-34) Other names for this lymphoid neoplasm include lethal midline granuloma, polymorphic reticulosis, and midline malignant reticulosis, although the preferred terminology currently is extranodal NK/T-cell lymphoma, nasal type.
Epstein-Barr virus in patients with polymorphic reticulosis (lethal midline granuloma) from China and Japan.
(5,6) Other differential diagnoses include intracranial astrocytoma or meningioma with nasal extension, neuroglial heterotopia, lymphoma/plasmacytoma, esthesioneuroblastoma, angiofibroma, lethal midline granuloma and, rarely, carcinoid tumor.
Classification of nasal granulomas Infectious Mycobacterial: Tuberculosis (human, bovine, or avian); atypical tuberculo- sis; leprosy Bacterial: Rhinoscleroma Treponemal: Syphilis; yaws Fungal: Mucormycosis; aspergillosis; blastomycosis; histoplasmosis; coccidiomycosis; rhinosporidiosis Parasitic: Leishmaniasis Noninfectious Wegener's granulomatosis Sarcoidosis Inclusion granuloma (silicosis; berylliosis) Foreign-body retention Malignant Lethal midline granuloma Nonspecific
The differential diagnosis is broad and includes such disorders as histoplasmosis, North American blastomycosis, South American blastomycosis, syphilis, midline granuloma, Wegener's granulomatosis, histiocytosis X, nocardiosis, necrotizing external otitis, lymphoma, bacterial otitis media, and cholesteatoma.