Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma
Objective: To report a case of lethal midline granuloma and discuss the diagnostic and treatment dilemma, and management. Methods Design: Case Report Setting: Tertiary Government Hospital Patient: One Results: A 15-year...
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| Format: | Article |
| Language: | English |
| Published: |
Philippine Society of Otolaryngology-Head and Neck Surgery, Inc.
2018-11-01
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| Series: | Philippine Journal of Otolaryngology Head and Neck Surgery |
| Subjects: | |
| Online Access: | https://pjohns.pso-hns.org/index.php/pjohns/article/view/273 |
| _version_ | 1819042169899450368 |
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| author | Ian Christian A. Gonzales |
| author_facet | Ian Christian A. Gonzales |
| author_sort | Ian Christian A. Gonzales |
| collection | DOAJ |
| description | Objective: To report a case of lethal midline granuloma and discuss the diagnostic and treatment dilemma, and management.
Methods
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
Results: A 15-year-old girl under treatment for pulmonary tuberculosis presented to the Emergency Room for epistaxis and a nasopalatine lesion. She was managed as a case of nasopalatine osteomyelitis for one month and discharged on antibiotics. She returned due to bleeding after being lost to follow up for 3 more months. Hemostasis, debridement and biopsy yielded atypical cells, possibly lymphoma. Immunohistochemistry confirmed the diagnosis of NK-cell lymphoma. Unfortunately, she expired prior to initiation of chemotherapy.
Conclusion: Clinicians must have a high index of suspicion for lethal midline granuloma in chronic, non-healing midline lesions. Multiple biopsies confirm the diagnosis, and earlier initiation of treatment may improve prognosis.
Keywords: Granuloma, lethal midline; Lymphoma, extranodal NK-T-cell |
| first_indexed | 2024-12-21T09:36:37Z |
| format | Article |
| id | doaj.art-03d748f6f45d412980c3620f08be291f |
| institution | Directory Open Access Journal |
| issn | 1908-4889 2094-1501 |
| language | English |
| last_indexed | 2024-12-21T09:36:37Z |
| publishDate | 2018-11-01 |
| publisher | Philippine Society of Otolaryngology-Head and Neck Surgery, Inc. |
| record_format | Article |
| series | Philippine Journal of Otolaryngology Head and Neck Surgery |
| spelling | doaj.art-03d748f6f45d412980c3620f08be291f2022-12-21T19:08:36ZengPhilippine Society of Otolaryngology-Head and Neck Surgery, Inc.Philippine Journal of Otolaryngology Head and Neck Surgery1908-48892094-15012018-11-0133210.32412/pjohns.v33i2.273Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic DilemmaIan Christian A. Gonzales0Cagayan de Oro Consortium of Otorhinolaryngology Head and Neck Surgery Northern Mindanao Medical CenterObjective: To report a case of lethal midline granuloma and discuss the diagnostic and treatment dilemma, and management. Methods Design: Case Report Setting: Tertiary Government Hospital Patient: One Results: A 15-year-old girl under treatment for pulmonary tuberculosis presented to the Emergency Room for epistaxis and a nasopalatine lesion. She was managed as a case of nasopalatine osteomyelitis for one month and discharged on antibiotics. She returned due to bleeding after being lost to follow up for 3 more months. Hemostasis, debridement and biopsy yielded atypical cells, possibly lymphoma. Immunohistochemistry confirmed the diagnosis of NK-cell lymphoma. Unfortunately, she expired prior to initiation of chemotherapy. Conclusion: Clinicians must have a high index of suspicion for lethal midline granuloma in chronic, non-healing midline lesions. Multiple biopsies confirm the diagnosis, and earlier initiation of treatment may improve prognosis. Keywords: Granuloma, lethal midline; Lymphoma, extranodal NK-T-cellhttps://pjohns.pso-hns.org/index.php/pjohns/article/view/273Granuloma, lethal midline; Lymphoma, extranodal NK-T-cell |
| spellingShingle | Ian Christian A. Gonzales Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma Philippine Journal of Otolaryngology Head and Neck Surgery Granuloma, lethal midline; Lymphoma, extranodal NK-T-cell |
| title | Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma |
| title_full | Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma |
| title_fullStr | Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma |
| title_full_unstemmed | Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma |
| title_short | Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma |
| title_sort | lethal midline granuloma in a 15 year old girl a diagnostic dilemma |
| topic | Granuloma, lethal midline; Lymphoma, extranodal NK-T-cell |
| url | https://pjohns.pso-hns.org/index.php/pjohns/article/view/273 |
| work_keys_str_mv | AT ianchristianagonzales lethalmidlinegranulomaina15yearoldgirladiagnosticdilemma |