Midline lethal granuloma
Associated with EBV
• Also called: Non-healing midline granuloma (or) midline granulomas reticulosis (or) Stewart’s granuloma (or) nasal T-cell lymphoma
• Nasal obstruction and epistaxis are the presenting features
• It is locally invasive causing destruction of
midfacial structures
Histologically polymorphic lymphoid tissue with
angiocentric and angioinvasive features is seen
• Cells express T cell markers like CD56
• Localized T-cell lymphoma is treated by radiation, while a disseminated disease requires
chemotherapy