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Non Wegener's midline granuloma with bilateral thalamic involvement
B Maiti1, S Mukherjee1, S Das1
1Bangur Institute of Neurology, Calcutta, India.
Neurology India
|March 16, 2018
Summary
This case study presents a rare instance of non-Wegener
Area of Science:
- Neurology
- Pathology
- Otolaryngology
Background:
- Midline destructive lesions, including non-Wegener's midline granuloma, can present with diverse neurological complications.
- Thalamic involvement in midline granuloma is exceptionally rare, posing diagnostic and therapeutic challenges.
Purpose of the Study:
- To report a rare case of non-Wegener's midline granuloma with unusual bilateral thalamic involvement.
- To highlight the diagnostic features and clinical presentation of this rare condition.
Main Methods:
- Clinical presentation of a 53-year-old male with a chronic nasal lesion and progressive hemiparesis.
- Histopathological examination of the nasal lesion revealing malignant midline reticulosis with angiocentric infiltrate.
- Cranial computed tomography (CT) scan demonstrating bilateral thalamic lesions.
Main Results:
- The patient exhibited a nonhealing midline nasal granuloma and neurological deficits consistent with thalamic and pyramidal tract involvement.
- Biopsy confirmed malignant midline reticulosis, an angiocentric infiltrative process.
- Imaging revealed bilateral thalamic abnormalities.
Conclusions:
- This case underscores the potential for midline granuloma to manifest with severe, bilateral central nervous system involvement, specifically the thalami.
- Early recognition and comprehensive investigation are crucial for managing such rare presentations of midline destructive lesions.
