Reticulocytes are not fully mature red blood cells, and the value in the peripheral blood reflects the function of bone marrow erythropoiesis and is therefore important for the diagnosis of hematological diseases and the observation of response to treatment. Reticulocytes are an important indicator of the hematopoietic function of the bone marrow red lineage as well as the efficacy of anemia and related diseases. How to check for heterogeneous reticulocytes? Heterotypic reticulocytes are most often seen in malignant granulomas. Granulomas are well-defined nodular lesions formed by macrophages and their evolving cells, which show restricted infiltration and proliferation. They are divided into infectious granulomas and foreign body granulomas. The prodromal phase is characterized by generalized typhoid or sinusitis. Intermittent nasal obstruction with aqueous or blood-tinged discharge. It may also manifest as dry crusting in the nose. Local examination is characterized by general inflammatory manifestations and granulomatous ulceration of the nasal septum may occur. This period lasts 4-6 weeks. In the active phase, the nose is poorly ventilated or completely obstructed, with pus and often foul odor. The general condition is fair, with weak sweating, poor appetite, often with low fever, a few with high fever, and ineffective treatment with general antibiotics. Local examination shows swelling, erosion and even ulceration of the nasal mucosa, which is granulomatous and has a grayish-white necrotic surface. Most of the lesions involve the inferior turbinate or nasal septum first, which may cause swelling and bulging of the external part of the nose in obvious cases, and the development of the lesions may cause perforation of the nasal septum or palate. This phase lasts from several weeks to several months. The end-stage patient is debilitated, cachectic and locally disfigured. The nasal mucosa, cartilage, bone and surrounding tissues such as the face, orbit, forehead and even the skull base can be severely and extensively destroyed, with swelling of the eyelids and conjunctiva, protrusion of the eyeballs and loss of vision. Eventually, death occurs due to failure, hemorrhage or complications of meningitis. Pathological sections show chronic nonspecific granulomatous lesions, and the disease can be diagnosed if heterogeneous reticulocytes or nuclear fission phases are present. Laboratory tests show low white blood cell count and accelerated erythrocyte sedimentation rate; immunoglobulin levels are high, and bacterial, fungal and viral cultures are mostly unremarkable. Tomographic radiographs and CT scans.