Harrison D F
Laryngoscope. 1987 Sep;97(9):1049-53.
Although differentiation of Wegener's granulomatosis from other destructive midline lesions is now clearly recognized by clinicians and pathologists, confusion persists regarding the management of what has erroneously been called "lethal midline granuloma." The experiences of 36 patients with destructive midline granuloma supports the view that probably all are manifestations of malignant lymphoma and should be treated as such. Although radical dosage radiotherapy will control most local lesions, dissemination of lymphoma may still occur despite absence of systemic disease at initial diagnostic work-up. Subsequent control with cytotoxic drugs is frequently unsuccessful, and it is suggested that chemotherapy should be given routinely to every patient with primary nasal lymphoma and possibly to those with polymorphic reticulosis or necrosis with atypical cellular exudate (NACE).
尽管临床医生和病理学家现已明确认识到韦格纳肉芽肿与其他破坏性中线病变的区别，但对于曾被错误地称为“致死性中线肉芽肿”的疾病的治疗仍存在困惑。36例破坏性中线肉芽肿患者的经验支持这样一种观点，即可能所有这些病例都是恶性淋巴瘤的表现，应按此进行治疗。尽管根治性剂量放疗可控制大多数局部病变，但尽管在初始诊断检查时没有全身性疾病，淋巴瘤仍可能发生播散。随后使用细胞毒性药物进行控制常常不成功，建议对每例原发性鼻淋巴瘤患者常规给予化疗，可能还应给予多形性网状细胞增生症或伴有非典型细胞渗出物的坏死（NACE）患者化疗。
