GERALD S. SPEAR, M.D.
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To the editor: Fauci, Johnson, and Wolff state that patients with midline granuloma have no "systemic manifestations or involvement of other organ systems" (1). They say nearly the same in their recent paper, wherein also, in listing clinicopathologic criteria that distinguish midline granuloma from Wegener's granulomatosis, they do not mention that the cellular infiltrate in these two disorders may differ (2).
That visceral lesions may be present in midline granuloma was emphasized in a case report in 1956, in which three previous histologically similar cases were also reviewed in detail (3). Skin involvement was particularly noteworthy. The differences in the
SPEAR GS. Midline Granuloma. Ann Intern Med. ;85:261–262. doi: 10.7326/0003-4819-85-2-261_2
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Published: Ann Intern Med. 1976;85(2):261-262.
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