山东大学耳鼻喉眼学报

• 论文 • 上一篇    下一篇

颈静脉球体瘤误诊分析

盛宏申,黄德亮,韩东一,武文明,杨伟炎   

  1. 解放军总医院耳鼻咽喉-头颈外科, 北京 100853
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2008-04-24 发布日期:2008-04-24
  • 通讯作者: 盛宏申

Misdiagnosis of glomus jugulare tumor

SHENG Hong-shen, HUANG De-liang, HAN Dong-yi, WU Wen-ming, YANG Wei-yan   

  1. Department of Otorhinolaryngology & Head and Neck Surgery, General Hospital of Chinese PLA, Beijing 100853, China
  • Received:1900-01-01 Revised:1900-01-01 Online:2008-04-24 Published:2008-04-24
  • Contact: SHENG Hong-shen

摘要: 目的提高颈静脉球体瘤的诊断水平,研究其误诊因素,降低误诊率。方法回顾性分析47例颈静脉球体瘤患者的临床、术前影像学及病理学诊断资料。结果47例中34例首诊时误诊(72.3%),误诊疾病分别为慢性中耳炎、分泌性中耳炎、外耳道肿物、神经性耳鸣、Bell麻痹、慢性咽喉炎、神经性耳聋、眩晕、突聋、声带麻痹。术前,影像误诊8例(17.0%),分别为慢性中耳炎及血管瘤;病理检查10例,误诊8例(80.0%),分别为外耳道炎性肉芽组织、血管瘤、炎性息肉、鳞状上皮及角化物。结论颈静脉球体瘤少见,临床症状无特征性表现,CT及MRI为重要的诊断依据,免疫组织化学检查有助于颈静脉球体瘤的诊断及鉴别诊断,医师对该病认识不足是导致误诊的主要原因。

关键词: 颈静脉球体瘤, 误诊, 诊断, 鉴别

Abstract: To improve the successful diagnosis rate of glomus jugulare tumor(GJT). MethodsClinical diagnosis, imaging diagnosis, and pre-operative pathological diagnosis were retrospectively analyzed in 47 GJT patients (18 males and 29 females) treated at our department from July 1987 to October 2006. ResultsIn this group, 34 patients failed to be diagnosed at the first time of medical consultation. The misdiagnosis ratio of the clinic, imaging and pathology was 34/47 (72.3%), 8/47 (17.0%) and 8/10 (80.0%). The disease was clinically misdiagnosed as chronic otitis media in 14/47 (29.8%), secretory otitis media 6/47(12.8%), external acoustic meatus mass 3/47(6.4%), nervous tinnitus 2/47 (4.3%), Bell′s palsy 2/47 (4.3%), chronic pharyngo-laryngitis 2/47 (4.3%), sensorineural deafness 2/47 (4.3%), vertigo 1/47 (2.1%), sudden hearing loss 1/47 (2.1%), and vocal cord paralysis 1/47 (2.1%). Pre-operative imaging studies were misdiagnosed as chronic otitis media in 7/47(14.9%) and hemangioma in 1/47(2.1%). The disease was pathologically misdiagnosed as inflammatory granulation tissue in 4 cases (40.0%), hemangioma in 2 (20.0%), inflammatory polyp in 1 (10.0%) and keratinized squamous epithelium in 1(10.0%). ConclusionsGJT is likely to be misdiagnosed. The main causes of misdiagnosis are: low incidence of the disease, nonspecific clinical symptoms and unawareness of the doctor. CT and MRI play important roles in diagnosis and also immunohistochemical analysis is beneficial in diagnosis and differential diagnosis of GJT.

Key words: Misdiagnosis, Diagnosis, Glomus jugulare tumor, differential

中图分类号: 

  • R730.2
[1] 朱明娟,邢凯,亢泽峰,刘健. 甲状腺相关性眼病的诊断及治疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(5): 110-113.
[2] 钟建文,刘大波,罗向前,黄振云,仇书要,程超,杨李强,易新华,曾锦鸿. 可穿戴设备在儿童阻塞性睡眠呼吸暂停诊断中的应用[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 30-33.
[3] 王仙,李颖,赵博军. 息肉样脉络膜血管病变诊疗进展[J]. 山东大学耳鼻喉眼学报, 2018, 32(2): 103-106.
[4] 李俏丽,李超,王薇,蔡永聪,孙荣昊,周雨秋,税春燕, 黄璐,涂静. 术后放化疗后复发并侵及侧颅底的原发性腮腺鳞状细胞癌一例[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 87-88.
[5] 陈红,曹慧玲,窦鑫,高下. 右侧鼻腔小细胞神经内分泌癌一例并文献复习[J]. 山东大学耳鼻喉眼学报, 2018, 32(1): 89-92.
[6] 王志祥,薛凯,魏宁,韩双,金春顺. 误诊为甲状腺肿物的颈部喉返神经神经鞘瘤一例[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 33-35.
[7] 敬尚林. 儿童上气道咳嗽综合征临床诊疗现状[J]. 山东大学耳鼻喉眼学报, 2017, 31(6): 87-91.
[8] 潘永杰,孙国臣,臧传善. 喉颗粒细胞瘤四例报告并文献复习[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 104-106.
[9] 孙莎莎,邱杰,臧传善,孙彦. 白塞病误诊为急性会厌炎两例[J]. 山东大学耳鼻喉眼学报, 2017, 31(5): 107-109.
[10] 刘平,潘晓春,卜川,徐杨斌. 五例患者韦伯偏振试验的局限性报道[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 115-116.
[11] 计早,阎艾慧. 鼻窦CT及MRI检查在单侧良性蝶窦病变中的临床应用[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 75-79.
[12] 接英,卢红双. 变应性结膜炎的诊疗策略[J]. 山东大学耳鼻喉眼学报, 2017, 31(3): 31-36.
[13] 王梦君综述, 李慧,马士崟审校. 鼻腔鼻窦恶性黑色素瘤的临床诊疗进展[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 116-120.
[14] 魏宁,赵雪,刘岩,刘悦,金春顺. 颈部Castleman病两例报告[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 123-126.
[15] 扈启迪,李耀君. 喉结核18例临床分析[J]. 山东大学耳鼻喉眼学报, 2017, 31(2): 85-89.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
No Suggested Reading articles found!