Abstract

Lethal midline granuloma is a T/natural killer cell lymphoma characterized by progressive ulcerationand necrosis of the nasal cavity or pharynx along the midline facial tissues. A case of lethalmidline granuloma in the palate of a 63-year-old woman is reported. The patient had a low-grade fever anda large ulcer with hemorrhage in the palate. Clinically, a malignant tumor was initially suspected becauseof rapid progressive ulceration, but inflammatory disease was pathologically diagnosed on examination ofa tissue specimen stained with hematoxylin and eosin. The definite diagnosis was made by in situ hybridizationwith Epstein-Barr virus RNA (EBV encoded small RNA- 1: EBER 1)-specific oligonucleotideprobes, which showed positive signals in small lymphocytes. The patient's condition became critical becauseof frequent hemorrhage, and she soon died.

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