Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma

Authors

  • Ian Christian A. Gonzales Cagayan de Oro Consortium of Otorhinolaryngology Head and Neck Surgery Northern Mindanao Medical Center

DOI:

https://doi.org/10.32412/pjohns.v33i2.273

Keywords:

Granuloma, lethal midline; Lymphoma, extranodal NK-T-cell

Abstract

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

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Published

2018-11-13

How to Cite

1.
Gonzales ICA. Lethal Midline Granuloma in a 15-Year-Old Girl: A Diagnostic Dilemma. Philipp J Otolaryngol Head Neck Surg [Internet]. 2018 Nov. 13 [cited 2025 Feb. 16];33(2):37-40. Available from: https://pjohns.pso-hns.org/index.php/pjohns/article/view/273

Issue

Vol. 33 No. 2 (2018): Philippine Journal of Otolaryngology-Head and Neck Surgery

Section

Case Reports

License

Copyright transfer (all authors; where the work is not protected by a copyright act e.g. US federal employment at the time of manuscript preparation, and there is no copyright of which ownership can be transferred, a separate statement is hereby submitted by each concerned author). In consideration of the action taken by the Philippine Journal of Otolaryngology Head and Neck Surgery in reviewing and editing this manuscript, I hereby assign, transfer and convey all rights, title and interest in the work, including copyright ownership, to the Philippine Society of Otolaryngology Head and Neck Surgery, Inc. (PSOHNS) in the event that this work is published by the PSOHNS. In making this assignment of ownership, I understand that all accepted manuscripts become the permanent property of the PSOHNS and may not be published elsewhere without written permission from the PSOHNS unless shared under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) license.