A Case for Diagnosis. Presented by Dr. H. J. Templeton.
G. B., a man, aged 27, a native of Tahiti, was presented for diagnosis before this society on Nov. 22, 1930. He had a proliferative granuloma on the anterior third of the tongue and on the mucous membrane of the left cheek. The lesions had gradually developed during a period of three years.Although the patient has been seen by a number of dermatologists and pathologists, no diagnosis has been made. Syphilis, a malignant growth, tuberculosis, deep mycotic granuloma, coccidioidal granuloma, frambesia, blastomycosis and rhinoscleroma have been considered, but laboratory evidence is not sufficient to support any of these diagnoses. Complement fixation tests, smears, cultures and guinea-pig inoculation have given inconclusive results. At the University of California, an organism (streptothrix) was isolated. Biopsy showed a plasmoma which was interpreted as a plasmocytoma by Dr. Ophüls and as tuberculosis by Dr.