耳鼻喉肉样瘤病:应引起警惕的病因?关于两份病例报告。

Q3 Medicine
Ines Naceur, Maysam Jridi, Sahar Skiri, Tayssir Ben Achour, Imed Ben Ghorbel, Monia Smiti, Fatma Said
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引用次数: 0

摘要

简介肉样瘤病是一种慢性炎症性疾病,以非酪氨酸坏死性上皮细胞肉芽肿为特征,可累及任何器官。耳鼻喉科(ENT)很少受累。我们报告了两例以耳鼻喉科发病的全身性肉样瘤病:一名 39 岁的女性患者,无病史,出现右侧颌下淋巴结肿大,鼻咽镜检查时伴有鼻咽部肿胀。淋巴结活检发现许多肉芽肿,其中有上皮样细胞和巨细胞。计算机断层扫描(CT)显示有多个淋巴结和间质性肺病。患者接受糖皮质激素治疗后,颌下肿胀和 CT 显示的淋巴结消失。另一名无病史的 39 岁女性因双侧鼻腔阻塞三个月的病史来到耳鼻喉科门诊就诊。鼻内窥镜检查发现鼻黏膜充血。她接受了抗生素治疗,但临床症状未见好转。头颅和面部骨骼 CT 扫描显示鼻咽后壁有局灶性隆起,伴有上颌窦、额窦和乙状窦粘膜增厚。随后进行了鼻腔和淋巴结活检,发现有肉芽肿性炎症,但无酪氨酸坏死。肺、淋巴结和鼻窦受累的肉样瘤病诊断成立。患者接受了糖皮质激素治疗,临床症状有所改善:结论:鼻咽和鼻窦受累在肉样瘤病中可能很少见,但可能是该病初期临床表现的一部分。因此,在耳鼻喉肉芽肿病的病例中应将跳蚤放入耳中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Ear, Nose, and Throat sarcoidosis: An etiology that should raise a flag? About two case reports.

Introduction: Sarcoidosis is a chronic inflammatory disease characterized by non-caseous necrotizing epithelial cell granulomas that can affect any organ. Ear, nose, and throat (ENT) involvement is rare. We report two cases of systemic sarcoidosis with ENT onset.

Observation: A 39-year-old woman with no medical history, presented with right submaxillary lymphadenopathy, associated with a nasopharyngeal swelling on the nasopharyngoscopy. Lymph node biopsy revealed numerous granulomas with epithelioid and giant cells. The computed tomography (CT) showed multiple lymph nodes along with interstitial lung disease. The diagnosis of sarcoidosis with pulmonary, mediastinal, lymph node, and nasopharyngeal involvement was retained and the patient was treated with glucocorticoids with disappearance of the submaxillary swelling and of the lymph nodes on the CT. Another 39-year-old woman, with no medical history, presented to the ENT clinic with a three-month history of bilateral nasal obstruction. Nasal endoscopy revealed hyperemia of the nasal mucosa. She was treated with antibiotics without clinical improvement. CT scan of the cranial and facial bones revealed a focal bulge at the nasopharynx's posterior wall, associated with a mucosal thickening of maxillary, frontal, and ethmoid sinuses. A nasal and a lymph node biopsy were then performed, revealing granulomatous inflammation without caseous necrosis. The diagnosis of sarcoidosis with pulmonary, lymph node, and sinonasal involvement was established. The patient was treated with glucocorticoids with clinical improvement.

Conclusion: Nasopharyngeal and sinus involvement may be rare in sarcoidosis but can be part of the initial clinical picture of the disease. Therefore, it should put the flea in the ear in case of ENT granulomatosis.

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来源期刊
Tunisie Medicale
Tunisie Medicale Medicine-Medicine (all)
CiteScore
1.00
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