Biopsy findings in malignant histiocytosis presenting as lethal midline granuloma.

Abstract

Nasal biopsy findings in malignant histiocytosis presenting clinically as lethal midline granuloma are characterised by necrosis and infiltration of atypical histiocytic cells with a diffuse positive reaction for non-specific esterase. This cellular character was common to midline malignant reticulosis, and midline malignant reticulosis and malignant histiocytosis are thought to be the same disease. Patterns of histiocytic infiltration in the nasal lesions of 19 cases are reported in this paper. Polymorphic and monomorphic patterns were observed in 11 and four cases respectively, on the initial biopsy, but subsequently the infiltrates frequently became monomorphic on serial biopsy. The reverse was not observed. Surface marker and cytochemical studies showed the true histiocytic nature of the proliferating cells, and necropsy findings justified the diagnosis of malignant histiocytosis.

Nation‐wide study of lethal mid‐line granuloma in Japan: Frequencies of Wegener's granulomatosis, polymorphic reticulosis, malignant lymphoma and other related conditions

“…The ages of the patients with WG, PR and ML in our present series were similar to those in the previous reports, i.e., earlier onset of disease in WG than in the other 2 diseases (Michaels and Gregory, 1977;Aozasa, 1982;Wolff et al, 1974). The preponderance of males among patients with PR and ML found in our series was also reported previously (Fechner and Lamppin, 1973;Michaels and Gregory, 1977;Aozasa, 1982), though our series comprises more female WG patients than that of Wolff et al (1974).…”

“…If necrotizing glomerulitis was diagnosed by renal biopsy, it was helpful for the diagnosis of WG (Godman and Churg, 1954). The diagnosis of PR was established from the polymorphous character of the infiltrated cells containing large, atypical, mono-or multinucleated cells, together with small lymphocytes, plasma cells, benign-looking macrophages, neutrophils and, much less frequently, eosinophils (Kassel et al, 1969;Fechner and Lamppin, 1973;Aozasa, 1982). Mitotic figures were generally frequent.…”

“…A review of the literature on LMG indicates that the PR is a relatively rare disease in Western countries: 9 cases in 30 years reported by the Mayo Clinic (Eichel et al, 1966) and 3 cases in 7 years (1974-1980) by the University of Cincinnati Medical Center (Crissman et al, 1982) in North America. By contrast, cases of LMG in Eastern countries comprised high frequencies of PR: 19 cases seen in 14 years (1965)(1966)(1967)(1968)(1969)(1970)(1971)(1972)(1973)(1974)(1975)(1976)(1977)(1978) in Osaka, Japan (Aozasa, 1982) and 5 cases in 1.5 years in Hong-Kong, China (Chan et al, 1987). These findings suggest a different frequency of PR among various ethnic groups and it seemed important to conduct an epidemiological study of LMG.…”

“…At present, both malignant lymphoma and PR (MMR) are thought to be neoplastic proliferations of lymphoreticular cells (Fechner and Lamppin, 1973;Michaels and Gregory, 1977). The nature of proliferating cells in PR is controversial (Aozasa, 1982;Ishii et al, 1982), although the results of recent immunohistochemical and molecular cytogenetic studies suggested a T-cell nature of the proliferating cells in this disease (Chan et al, 1987;Gaulard et al, 1988).…”

Chronological Changes in Incidences of Polymorphic Reticulosis in Korea and Japan

“…The diagnosis of PR was established from the polymorphous characteristics of the infiltrating cells, together with small lymphocytes, plasma cells, bening-looking macrophages, neutrophils, and much less frequently eosinophils (fig. 2) [2, 10]. Mitotic figures were generally frequent.…”