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idiopathic midline destructive disease |
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idiopathic midline destructive disease (IMDD), a disorder of unknown cause characterized by ulceration and necrosis of the midline facial tissues and obstruction of the upper airways. IMDD develops without systemic involvement. idiopathic midline destructive disease Lethal midline granuloma of Stewart A diagnosis of exclusion–criteria, consist of a midline granuloma of unknown etiology which, unlike most granulomas of the midline, are secondary manifestations
of a primary process–eg, vasculitis–eg, Wegener's granulomatosis, malignancy–eg, lymphoma, nasal carcinoma, infections–eg, destructive fungal infections in immunocompromised Pts Treatment RT. See Lethal midline
granuloma, Midline granuloma.
Idiopathic midline destructive disease
1. Local destruction of upper respiratory tract
2. No progression to system disease–average follow-up, 7 years
3. Acute/chronic inflammation with variable necrosis, without vasculitis, atypia or malignancy
4. No evidence of infection or malignancy
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6-8) Many authors once listed polymorphic reticulosis, malignant midline reticulosis, lymphomatoid granulomatosis, malignant destructive granuloma, and idiopathic midline destructive disease as separate entities in the etiology of midfacial necrotizing lesions. |
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