原发局限性扁桃体淀粉样变1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2020.237

摘要/Abstract

摘要： 目的探讨原发局限性扁桃体淀粉样变的临床表现、诊断思维、治疗方法及预后,以便对其进行早期诊断。方法回顾性分析1例原发局限性扁桃体淀粉样变患者的临床资料并复习相关文献进行总结。结果原发局限性扁桃体淀粉样变早期缺乏特异性症状,疾病进展常较快,临床表现常为双侧扁桃体不对称增长或双侧迅速增大导致的咽部异物感为主,其余包括扁桃体赘生物、溃疡、咽干、咽痒、咽痛、吞咽困难等非特异性表现。对无痛性扁桃体肥大且无炎症症状患者,如若病程较短、双侧扁桃体明显不对称、表面溃疡和质地硬等,都应先行病理活检。结论原发局限性扁桃体淀粉样变临床及影像表现无特异性,因而详细病史采集、全身系统检查、病理活检等有效手段对于早期诊断疾病非常重要。

关键词: 原发局限性, 淀粉样变, 扁桃体, 临床表现, 病理活检

Abstract: Objective To investigate the clinical characteristics, diagnosis, treatment, and prognosis of primary localized tonsil amyloidosis, to enable its early diagnosis. Methods A patient with primary localized tonsil amyloidosis was retrospectively reviewed, along with previous cases of primary localized tonsil amyloidosis found in the literature. Results The clinical manifestations of primary localized tonsil amyloidosis lack specificity, and its early manifestations are often atypical. Besides, the disease often rapidly progresses. The clinical manifestations are mainly a pharyngeal foreign body sensation caused by the asymmetric growth or rapid enlargement of the bilateral tonsil. Other non-specific manifestations include tonsil growth, an ulcer, dry pharynx, pharynx itch, pharynx pain, and dysphagia. For patients with painless hypertrophy of the tonsil and no inflammatory symptoms, a pathological biopsy should be performed if bilateral tonsil asymmetry is apparent, there is a surface ulcer, the texture is hard, or the history is short. Conclusion The clinical and imaging manifestations of primary localized tonsil amyloidosis are non-specific. Therefore, it is imperative to carefully consider the patient's medical history, systemic examination findings, and pathological biopsy findings to diagnose primary localized tonsil amyloidosis at an early stage.

Key words: Primary limitations, Amyloidosis, Tonsils, Clinical manifestations, Pathological biopsy

中图分类号:

R766

冯晨,金霄雪,韩莹莹,邹娟娟,李延忠, 王岩. 原发局限性扁桃体淀粉样变1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2020, 34(6): 99-103.

FENG Chen, JIN Xiaoxue, HAN Yingying, ZOU Juanjuan, LI Yanzhong, WANG Yan. Primary localized tonsil amyloidosis: a case report and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2020, 34(6): 99-103.

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