Polymorphic extranodal lymphoma, expressing NK or rarely cytotoxic T cell phenotype
Alternate/Historical Names
Polymorphic reticulosis
Lethal midline granuloma
Angiocentric T cell lymphoma
Diagnostic Criteria
Primarily extranodal
Most common site is nose
Nodes may be involved secondarily
Necrosis nearly always present
Vascular destruction may be seen
Ulceration common
Pseudoepitheliomatous hyperplasia may be seen
Wide range of appearance from small to large cell
Frequently mixed
Inflammatory cells may be prominent
Cytoplasm may be clear with azurophilic granules on Giemsa stained cytologic preparations
CD56 positive
Rare cases may lack CD56, but must then be EBV+, CD3+ and cytotoxic protein+
EBV positive
May be lacking in some extranasal, North American or Western European cases
Note that the term "nasal type" originally applied only to lymphomas of this type that occurred in sites other than the nasal cavity; it now includes nasal and extra-nasal locations
Dita Gratzinger MD PhD
Yasodha Natkunam MD PhD
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Initial posting : September 1, 2007
Supplemental studies
Immunohistology and Flow
NK type
CD56
100%
EBV LMP
Positive, less sensitive than in situ hybridization
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