Progressive granulomatous ulcer necrosis

Introduction Progressive granuloma ulcer necrosis can be seen in malignant granuloma, malignant granuloma, also known as necrotizing granuloma, is a rare progressive necrotizing ulcer, more destructive than malignant tumor.

Cause

Necrotic granuloma - the cause is unknown, there are currently oncology, autoimmune theory, infection theory, trauma induced.

Pathology can be divided into two categories:

1. Tumor-like type: equivalent to the old malignant granuloma or fatal midline granuloma (ie Stewart's type), mostly originated in the nasal cavity, died of major bleeding or extreme exhaustion.

2. Allergic reactions: Wegener's type is this type. Destructive is milder than tumors, and its destruction and repair can be performed simultaneously. It is divided into two types: the typical lesion is centered on the respiratory tract, involving a variety of internal organs, combined with nephritis; atypical is mainly invading the nose and lungs. Can die of uremia.

an examination

Related inspection

White blood cell count (WBC) white blood cell classification count

It is not difficult to diagnose malignant granuloma based on clinical manifestations, histopathology and laboratory tests. Diagnostic points:

1 All cases of progressive granulogenous ulcer necrosis occurring in the nose and face should consider the disease first.

2 pathological examination: chronic non-specific granulomatous lesions, while seeing atypical reticulocytes or mitotic phase, you can diagnose the disease.

3 local damage is serious, but the whole body performance is still good.

4 local lymph nodes are generally not enlarged.

5 laboratory examination: white blood cell count is low, erythrocyte sedimentation rate is accelerated.

6 advanced patients often have persistent relaxation heat and progressive weight loss and systemic failure. Early diagnosis and treatment have a better prognosis. Clinical attention should be paid to the identification of nasal tuberculosis, atrophic rhinitis, malignant tumors, etc. The only method is repeated biopsy.

Differential diagnosis

Clinical attention should be paid to the identification of nasal tuberculosis, atrophic rhinitis, malignant tumors, etc. The only method is repeated biopsy. Nose tuberculosis: is a disease of tuberculosis of the nose. There are primary and secondary points, the primary may be caused by airborne, direct or indirect contact, secondary to tuberculosis lesions or other areas of tuberculosis.

Atrophic rhinitis: Atrophic rhinitis, also known as stinky rhinitis, is a slow-developing nasal atrophic inflammation characterized by atrophy of the nasal mucosa, periosteum, and bone. Severe with a typical stench, called snoring. More often than adolescence, women are more common than men. The cause is still unknown. Mainly manifested as dryness of the nose and nasopharynx, nasal congestion, nosebleeds, intranasal purulent sputum, olfactory disturbance, exhalation odor, headache, dizziness and so on.

Malignant tumors: Tumors are classified into benign tumors and malignant tumors. Generally speaking, cancer refers to malignant tumors. Malignant tumors are histologically divided into epithelial cancers and non-epithelial sarcomas and blood cancers. The distinction between benign and malignant is often determined by clinical prognosis. The identification of the two can be seen in the table below, but there are many exceptions, and it is often difficult to make a strict distinction. This is also determined by the environmental conditions in which each tumor cell is located. Some scholars advocate that there is a continuous stage between benign tumors and malignant tumors, but some benign, tumors such as prostate adenoma, breast fibroadenomas, uterine fibroids, glomus tumors, etc. are regulated by endocrine, nervous and other organisms. The mechanism has a close relationship with tissue proliferation, and some scholars claim that it is essentially different from malignant tumors.

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