Michaels L, Gregory M M
J Clin Pathol. 1977 Apr;30(4):317-27. doi: 10.1136/jcp.30.4.317.
In a histological study of biopsy and postmortem material from 30 cases of nasal disease in which a clinical diagnosis of 'midline granuloma' or Wegener's granuloma had been given, we selected 10 cases on the basis of the presence of widespread coagulative necrosis and atypical cells. Evidence is provided that such changes represent a malignant neoplasm of histiocytic lymphoma type. Local invasion and spread to cervical and more distant lymph nodes, spleen, liver, and kidney were seen in some of the cases. Erythrophagocytic activity was marked in the spleen in three cases and histiocytic infiltration of the bone marrow in two cases, indicating a more generalised activity of histiocytic cells. Terms such as 'malignant granuloma' should be abandoned. In obstructive and ulcerating conditions of the nose efforts should be concentrated on making an accurate histological diagnosis.
在一项对30例鼻部疾病活检及尸检材料的组织学研究中，这些病例临床诊断为“中线肉芽肿”或韦格纳肉芽肿，我们基于广泛的凝固性坏死和非典型细胞的存在选择了10例。有证据表明，这些变化代表组织细胞淋巴瘤类型的恶性肿瘤。部分病例可见局部侵袭并扩散至颈部及更远的淋巴结、脾脏、肝脏和肾脏。3例脾脏有明显的红细胞吞噬活性，2例骨髓有组织细胞浸润，表明组织细胞有更广泛的活性。“恶性肉芽肿”等术语应摒弃。对于鼻部的阻塞性和溃疡性病变，应集中精力做出准确的组织学诊断。
