Advanced

AJNR - American Journal of Neuroradiology

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Borges, A. Articles by Lufkin, R. Search for Related Content PubMed PubMed Citation Articles by Borges, A. Articles by Lufkin, R.

American Journal of Neuroradiology 21:331-336 (2 2000)
© 2000 American Society of Neuroradiology

ARTICLE

Midline Destructive Lesions of the Sinonasal Tract: Simplified Terminology Based onHistopathologic Criteria

Alexandra Borges^,a, James Fink^a, Pablo Villablanca^a, Roy Eversole^a and Robert Lufkin^a

^a From the Departments of Radiological Sciences (A.B., J.F., P.V., R.L.) and Oral Pathology (R.E.), University of California, Los Angeles.

BACKGROUND AND PURPOSE: Destructive lesions of the sinonasal tract, lacking a discernible etiology and referred to as midline destructive disease, have been pathologically classified in accordance with a variety of confusing terms. Development of new pathologic concepts and immunohistochemical techniques has provided a fresh understanding of these lesions, and, as a result, they can be unified into two distinct pathologic groups: Wegener's granulomatosis and non-Hodgkin's T-cell lymphoma.

METHODS: We retrospectively reviewed the imaging studies and pathologic specimens of seven patients with prior diagnoses included in the midline destructive disease group. The specimens were reviewed by an oral pathologist using currently accepted pathologic criteria and the newly available immunohistochemical markers CD20, CD45, and CD45RO. Lesions were classified as non-Hodgkin's T-cell lymphomas when positive for CD45 and CD45RO and negative for CD20, and as Wegener's granulomatosis in the presence of noncaseating multinucleated giant cell granulomas and necrotizing vasculitis.

RESULTS: Three of the lesions were reclassified as Wegener's granulomatosis and four as T-cell lymphomas after applying these pathologic criteria. There were no distinguishing imaging findings between Wegener's granulomatosis and non-Hodgkin's T-cell lymphoma.

CONCLUSION: The current pathologic classification for midline destructive disease should be incorporated into the radiologic lexicon and the use of terms from the old classification system, such as idiopathic midline granuloma and lethal midline granuloma, should be abandoned and no longer be used in radiologic reports.

This article has been cited by other articles:

				M. P. Valencia and M. Castillo Congenital and Acquired Lesions of the Nasal Septum: A Practical Guide for Differential Diagnosis RadioGraphics, January 1, 2008; 28(1): 205 - 223. [Abstract] [Full Text] [PDF]