鼻腔呼吸道上皮腺瘤样错构瘤1例并文献复习

doi:10.6040/j.issn.1673-3770.0.2021.464

摘要/Abstract

摘要： 目的探讨鼻腔呼吸上皮性腺瘤样错构瘤(REAH)的临床、影像、病理学特征及治疗。方法分析1例鼻腔REAH患者的临床资料并复习相关文献进行总结。结果鼻腔REAH临床表现常以鼻塞、嗅觉减退为主。影像学方面,嗅裂增宽>10 mm是本病在CT上的特征性表现。本病确诊主要依靠病理检查,其显微镜下特点是大量内衬呼吸道纤毛上皮的腺体显著增生。结论鼻腔REAH临床表现无特异性,因而影像学及组织学检查对本病的早期诊断尤其重要。内镜下切除肿瘤是本病的最佳治疗手段。

关键词: 呼吸道上皮腺瘤样错构瘤, 鼻腔, 错构瘤, 嗅裂, 病理活检

Abstract: Objective To explore the clinical, imaging, pathological features and treatment of nasal respiratory epithelial adenomatous hamartoma(REAH). Methods We report the case of a patient with REAH in the nasal cavity and review prior cases of REAH in the nasal cavity published in the literature. Results The most frequent symptoms of REAH in the nasal cavity are nasal obstruction and olfactory impairment. In terms of imaging, olfactory cleft widening greater than 10 mm on computed tomography is characteristic of REAH. The diagnosis of REAH relies mainly on pathology; this malformationis characterized by a prominent glandular proliferation lined by ciliated respiratory epithelial cells. Conclusion The clinical symptoms of REAH are nonspecific. Therefore,imaging and histopathological examinations are especially important for its early diagnosis. Endoscopic resection is the treatment of choice for REAH.

Key words: Respiratory epithelial adenomatoid hamartoma, Nasal Cavity, Hamartoma, Olfactory cleft, Pathological biopsy

中图分类号:

R765.2

岑艳芳,伍映芳,胡玉莹,孔喆,梁艳,李兴亚,夏纪严. 鼻腔呼吸道上皮腺瘤样错构瘤1例并文献复习[J]. 山东大学耳鼻喉眼学报, 2023, 37(1): 30-34.

CEN Yanfang, WU Yingfang, HU Yuying, KONG Zhe, LIANG Yan, LI Xingya, XIA Jiyan. Respiratory epithelial adenomatoid hamartoma in the nasal cavity: a case report and literature review[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(1): 30-34.

参考文献

[1] Al-Musaileem N, Qazi IM, Bastaki JM, et al. An atypical presentation of a Respiratory Epithelial Adenomatoid Hamartoma, a case report[J]. Ann Med Surg(Lond),2019, 46: 27-30. doi:10.1016/j.amsu.2019.08.007
[2] Wenig BM, Heffner DK. Respiratory epithelial adenomatoid hamartomas of the sinonasal tract and nasopharynx: a clinicopathologic study of 31 cases[J]. Ann Otol Rhinol Laryngol,1995,104(8):639-645. doi:10.1177/000348949510400809
[3] Davison WL, Pearlman AN, Donatelli LA, et al. Respiratory epithelial adenomatoid hamartomas: An increasingly common diagnosis in the setting of nasal polyps[J]. American Journal of Rhinology & Allergy, 2016, 30(4):139. doi:10.2500/ajra.2016.30.4338
[4] Schertzer JS, Levy JM, Wise SK, et al. Is respiratory epithelial adenomatoid hamartoma related to central compartment atopic disease?[J]. Am J Rhinol Allergy,2020, 34(5): 610-617. doi:10.1177/1945892420914212
[5] Nguyen DT, Jankowski R, Bey A, et al. Respiratory epithelial adenomatoid hamartoma is frequent in olfactory cleft after nasalization[J]. Laryngoscope, 2020, 130(9): 2098-2104. doi:10.1002/lary.28298
[6] Flavin R, Russell J, Phelan E, et al. Chondro-osseous respiratory epithelial adenomatoid hamartoma of the nasal cavity: a case report[J]. International Journal of Pediatric Otorhinolaryngology, 2005, 69(1): 87-91. doi:10.1016/j.ijporl.2004.07.010
[7] 房高丽,朴颖实,于文玲,等. 鼻腔呼吸道上皮腺瘤样错构瘤临床和影像学分析[J]. 中国耳鼻咽喉头颈外科,2020,27(5):267-270. doi:10.16066/j.1672-7002.2020.05.009 FANG Gaoli, PIAO Yingshi, YU Wenling, et al. Clinical and imaging features of respiratory epithelial adenomatoidhamartoma in nasal cavity[J]. Chinese Archives of Otolaryngology-Head and Neck Surgery, 2020, 27(5):267-270. doi:10.16066/j.1672-7002.2020.05.009
[8] Rom D, Lee M, Chandraratnam E, et al. Respiratory epithelial adenomatoid hamartoma: an important differential of sinonasal masses[J]. Cureus,2018,10(4):e2495. doi:10.7759/cureus.2495
[9] 于倩倩,关鸽,张念凯,等. 鼻腔嗅裂区呼吸道上皮腺瘤样错构瘤的CT影像表现[J]. 山东大学耳鼻喉眼学报,2018,32(3):76-81. doi:10.6040/j.issn.1673-3770.0.2017.355 YU Qianqian, GUAN Ge, ZHANG Niankai, et al. Characteristics of respiratory epithelial adenomatoid hamartomas in the nasal olfactory cleft on computed tomography[J]. Journal of Otolaryngology and Ophthalmology of Shandong University,2018, 32(3): 76-81. doi:10.6040/j.issn.1673-3770.0.2017.355
[10] Safi C, Li C, Tabaee A, et al. Outcomes and imaging findings of respiratory epithelial adenomatoid hamartoma: a systematic review[J]. International Forum of Allergy & Rhinology, 2019, 9(6): 674-680. doi:10.1002/alr.22298
[11] 张胜男, 姜彦, 于龙刚, 等. 鼻腔呼吸道上皮腺瘤样错构瘤临床特征分析[J].中华耳鼻咽喉头颈外科杂志, 2019, 54(5): 373-376. doi:10.3760/cma.j.issn.1673-0860.2019.05.011 ZHANG Shengnan, JIANG Yan, YU Longgang, et al. Analysis of clinical features of respiratory epithelial adenomatoid hamartoma in the nasal cavity[J]. Chinese journal of otorhinolaryngology head and neck surgery, 2019, 54(5): 373-376. doi:10.3760/cma.j.issn.1673-0860.2019.05.011
[12] Safi C, Li C, Tabaee A, et al. Outcomes and imaging findings of respiratory epithelial adenomatoid hamartoma: a systematic review[J]. Int Forum Allergy Rhinol, 2019, 9(6): 674-680. doi:10.1002/alr.22298
[13] Kumar SA, O'Meara C, Fredericks S, et al. Beware the respiratory epithelial adenomatoid hamartoma-a malignant masquerador[J]. J Surg Case Rep, 2021, 2021(2): b7. doi:10.1093/jscr/rjab007
[14] 向世凤,李必强,杨健,等. 鼻腔鼻窦少见良性肿瘤及类肿瘤样病变的CT和磁共振成像诊断[J]. 实用放射学杂志, 2020, 36(6): 880-884. doi:10.3969/j.issn.1002-1671.2020.06.007 XIANG Shifeng, LI Biqiang, YANG Jian, et al. CT and MRI diagnosis of rare benign tumors and tumor-like lesions in nasal cavity and sinus[J]. Journal Of Practical Radiology, 2020, 36(6): 880-884. doi:10.3969/j.issn.1002-1671.2020.06.007
[15] 周亚美,杨昕,刘文惠,等. 鼻窦CT测量在呼吸道上皮腺瘤样错构瘤术前诊断中应用[J]. 临床军医杂志, 2019, 47(12):1325-1328. doi:10.16680/j.1671-3826.2019.12.15 ZHOU Yamei, YANG Xin, LIU Wenhui, et al. Application of sinus CT measurement in preoperative diagnosis of respiratory epithelial adenomatoid hamartoma[J]. Clinical Journal Of Medical Officers, 2019, 47(12): 1325-1328. doi:10.16680/j.1671-3826.2019.12.15
[16] Shanbag R, Patil P, Rani SH, et al. Respiratory epithelial adenomatoid hamartoma(REAH)in the ofactory cleft: often masked by bilateral nasal polyps[J]. Indian J Otolaryngol Head Neck Surg, 2019, 71(Suppl 3): 2121-2126. doi:10.1007/s12070-018-1562-6
[17] Li R, Saluja K, Lin M, et al. Sinonasal hamartomas: from nasal chondromesenchymal hamartoma to respiratory epithelial adenomatoid hamartoma. Report of six cases and review of the literature[J]. Int J Surg Pathol, 2022:135139437. doi:10.1177/10668969211064211
[18] Agrawal SR, Joshi AA, Dhorje N, et al. Respiratory epithelial adenomatoid hamartoma: a diagnostic challenge in sinonasal lesions[J]. BMJ Case Rep, 2019, 12(8):e230082. doi:10.1136/bcr-2019-230082
[19] Patel DN, Koshkareva YA, Mcfarland M, et al. A case of respiratory epithelial adenomatoid hamartoma(REAH)in a patient with history of radiation exposure[J]. Case Reports in Otolaryngology, 2019: 1-3. doi:10.1155/2019/9473608

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