Idiopathic midline destructive disease--does it exist?

There is controversy whether idiopathic mid-line destructive disease remains a valid entity, some authors considering that such cases are unrecognized malignant lymphoma or Wegener's disease. A case is presented in which numerous nasal biopsies over several years failed to show evidence of either lymphoma or Wegener's disease. Molecular genetic analysis of archival tissue did not demonstrate a monoclonal lymphoid population. It is proposed that idiopathic mid-line destructive disease remains a valid description in a small number of cases.