Summary
Lymphomatoid granulomatosis (LYG) has been recognized as a peculiar disease which primarily affects the lungs and occasionally the upper respiratory tract. Typical histopathologic lesions present features of a nonneoplastic lymphoproliferative disorder associated with necroses of the infiltrated tissues and with angiodestructive processes. The authors observed a peculiar case in which lesions typical for LYG first developed in the striated muscles. In this case multiple tumorous muscular infiltrates and affections of the pharynx, larynx, paranasal sinuses, and orbita preceded the infiltration of the lung, which was first recognized 6 months after the first muscular infiltrate and 2 months before death.
Because primary muscular manifestation of LYG has never been reported, this case is remarkable both for its unusual manifestation and for its striking irresponseveness towards therapy. Clinical and experimental data suggest impairment of T-cell functions.
Zusammenfassung
Die lymphomatoide Granulomatose (LYG) wird als besonderes Krankheitsbild angesehen, das primär die Lungen und gelegentlich den oberen Respirationstrakt befällt. Die typischen histopathologischen Veränderungen zeigen eine nichtneoplastische lymphoproliferative Erkrankung, verbunden mit Nekrosen im infiltrierten Gewebe und mit angiodestruktiven Prozessen. Die Autoren beschreiben einen Fall, in dem die für die lymphomatoide Granulomatose typischen Veränderungen zuerst in der quergestreiften Muskulatur auftraten. In diesem Fall fanden sich multiple tumoröse Muskelinfiltrate und Infiltrate in Pharynx, Larynx, den paranasalen Sinus und in der Orbita vor der Lungeninfiltration, die 6 Monate nach dem ersten Muskelinfiltrat und 2 Monate vor dem Tod nachgewiesen wurde. Da eine primär muskuläre Manifestation der lymphomatoiden Granulomatose bis jetzt nicht beschrieben wurde, ist dieser Fall wegen seiner ungewöhnlichen Manifestation und der ausgesprochenen Therapieresistenz bemerkenswert. Die klinischen und experimentellen Daten sprechen für eine gestörte T-Zellfunktion.
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References
Carrington CB, Liebow AA (1966) Limited forms of angiitis and granulomatosis of Wegener's type. Am J Med 41:497–527
Friedman IF (1977) Midline granuloma. Ann Intern Med 86:663
Hammar SP, Gortner D, Sumida S, Bockus D (1977) Lymphomatoid granulomatosis: Association with retroperitoneal fibrosis and evidence of impaired cell-mediated immunity. Am Rev Respir Dis 115:1045–1050
Harrison DFN (1974) Non-healing granulomata of the upper respiratory tract. Br Med J 4:205–209
Israel HL, Patchefsky AS, Saldana MJ (1977) Wegener's Granulomatosis, lymphomatoid granulomatosis, and benign lymphocytic angiitis and granulomatosis of lung. Ann Intern Med 87:691–699
Katzenstein ALA, Carrington CB, Liebow AA (1979) Lymphomatoid Granulomatosis. A clinicopathologic study of 152 cases. Cancer 43:360–373
Lee SC, Roth LM, Brashear RE (1976) Lymphomatoid granulomatosis. A clinicopathologic study of four cases. Cancer 38:846–853
Liebow AA, Carrington CB, Friedman PJ (1972) Lymphomatoid granulomatosis. Hum Pathol 3:457–558
Saldana M, Patchefsky AS, Israel HI, Atkinson GW (1977) Pulmonary angiitis and granulomatosis. The relationship between histological features, organ involvement and response to treatment. Hum Pathol 8:391–409
Schjolseth SA, Blom GP (1978) Lymphomatoid granulomatosis of the lung, liver and spleen. Scand J Haematol 21:104–108
Weisbrot IM (1976) Lymphomatoid granulomatosis of the lung, associated with a long history of benign lymphoepithelial lesions of the salivary glands and lymphoid interstitial pneumonitis. Report of a case. Am J Clin Pathol 66:792–801
Wolff SM, Fauci AS, Horn RG, Dale DC (1974) Wegener's granulomatosis. Ann Intern Med 81:513–525
Yockey CC, Leichter SB, Hampton JR, III (1977) Lymphomatoid granulomatosis presenting as fever of unknown origin. JAMA 237:2633–2634
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We acknowledge the financial support provided by the Fonds Kampf dem Krebs
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Schmalzl, F., Gasser, R.W., Weiser, G. et al. Lymphomatoid granulomatosis with primary manifestation in the skeletal muscular system. Klin Wochenschr 60, 311–316 (1982). https://doi.org/10.1007/BF01716808
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DOI: https://doi.org/10.1007/BF01716808