McDonald T J, DeRemee R A, Harrison E G, Facer G W, Devine K D
Laryngoscope. 1976 Jul;86(7):936-45. doi: 10.1288/00005537-197607000-00006.
Confusion surrounds the entity known as "lethal midline granuloma". Partly responsible is the lack of specificity in this term. "Polymorphic reticulosis" has been used as a term to describe the morphology of the disease. Thirty-two cases illustrate the protean features of this disease. Although it commonly presents in the head and neck, other sites such as the lungs, kidneys, skin, and gastrointestinal tract may be involved, either alone or in conjunction with lesions of the head and neck. Clinically, it is easily confused with Wegener's granulomatosis. Histopathologic differentiation, however, is both feasible and important. Wegener's granulomatosis is treatable with steroids with or without cyclophosphamide; polymorphic reticulosis confined to one site responds to irradiation. In polymorphic reticulosis, thhe best results of treatment are obtained in localized lesions of the upper airway treated early with irradiation; a poorer outcome is associated with multifocal involvement, which necessitates systemic therapy.
围绕“致死性中线肉芽肿”这一实体存在诸多混淆。部分原因在于该术语缺乏特异性。“多形性网状细胞增多症”曾被用作描述该疾病形态的术语。32例病例说明了这种疾病的多种特征。尽管它通常出现在头颈部，但其他部位，如肺、肾、皮肤和胃肠道，也可能单独或与头颈部病变一起受累。临床上，它很容易与韦格纳肉芽肿混淆。然而，组织病理学鉴别既可行又重要。韦格纳肉芽肿可使用类固醇联合或不联合环磷酰胺进行治疗；局限于一个部位的多形性网状细胞增多症对放疗有反应。在多形性网状细胞增多症中，对上呼吸道早期局限性病变进行放疗可获得最佳治疗效果；多灶性受累则预后较差，需要进行全身治疗。
