(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
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.