The association of peculiar giant-cellular granulomatous lesions of the upper respiratory tract and the lungs or other organs with necrotizing vascular lesions resembling polyarteritis nodosa has been seldom reported. Klinger (1931) Rosenblatt, 1942; Rich, 1942a Rich, , 1942b Rich and Gregory, 1943;Lichtenstein and Fox, 1946;Duff, More, and McMillan, 1946;van The salient features, according to Weinberg, were a history of long-standing infection of the upper respiratory tract with the development of ulceration of the nose, mouth, and trachea and with the final development of polyarteritis nodosa. R6ssle's case showed involvement of the paranasal sinuses and the ear. Wegener's three cases followed a peculiar granulomatous rhinitis. Lindsay's case apparently first manifested itself as a painless depression of the bridge of the nose about a year before death due to polyarteritis nodosa. Also, one case of polyarteritis nodosa of the series reported by Davson, Ball, and Platt (1948), and that of Olesen and Myschetzky (1949), both had had a Caldwell-Luc operation performed for chronic nasal discharge and maxillary sinusitis some months before death from polyarteritis nodosa. We observed an example of this remarkable association, and the following is an account of the clinical picture, post-mortem findings, and some aspects of the pathogenesis.
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