鼻窦髓外造血一例报告及文献复习。

IF 2.3 Q1 OTORHINOLARYNGOLOGY
Allergy & Rhinology Pub Date : 2020-04-21 eCollection Date: 2020-01-01 DOI:10.1177/2152656720918874
Carly A Clark, Cameron P Worden, Brian D Thorp, Charles S Ebert, Adam M Zanation, Brent A Senior, Steven M Johnson, Wade G McClain, Adam J Kimple
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引用次数: 2

摘要

背景:髓外造血(EMH)发生在血液系统疾病患者中,但很少发生在鼻窦内。我们报告一例EMH在一个17岁的男性镰状细胞病(SCD)谁提出了枕部疼痛和鼻窦炎。计算机断层扫描(CT)显示不均匀混浊的右上颌窦有关过敏性真菌鼻窦炎或真菌球骨侵蚀。他被带到手术室进行内窥镜活检和有限的内窥镜鼻窦手术。肉眼可见,他的上颌窦充满了针状骨组织。最终病理显示活跃的造血骨髓充满鼻窦。方法:报告1例鼻窦EMH病例并复习文献。结果:我们鉴定了14篇文章,15例患者。EMH通常与SCD或地中海贫血相关。平均出现年龄为30岁。男性的性别偏好比例为11:15。最常见的症状是头痛和鼻塞(两者均占33%)。最常见的CT表现是软组织膨胀性肿块(73%)。最常见的受累部位是上颌窦(60%)。结论:本病例报告提醒我们,EMH是鼻窦混浊的罕见原因,特别是在SCD或地中海贫血患者中。造血组织的扩张在CT上可被识别为窦性肿块。通过认识慢性贫血的潜在表现,可以做出准确及时的诊断。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Extramedullary Hematopoiesis in the Sinonasal Cavity: A Case Report and Review of the Literature.

Extramedullary Hematopoiesis in the Sinonasal Cavity: A Case Report and Review of the Literature.

Extramedullary Hematopoiesis in the Sinonasal Cavity: A Case Report and Review of the Literature.

Extramedullary Hematopoiesis in the Sinonasal Cavity: A Case Report and Review of the Literature.

Background: Extramedullary hematopoiesis (EMH) occurs in patients with hematologic disorders, but rarely within the paranasal sinuses. We report a case of EMH in a 17-year-old male with sickle cell disease (SCD) who presented with occipital pain and sinusitis. A computed tomography (CT) scan demonstrated heterogeneous opacification of the right maxillary sinus concerning for allergic fungal sinusitis or a fungal ball with bony erosion. He was taken to the operating room for endoscopic biopsy and a limited endoscopic sinus surgery. Grossly, his maxillary sinus was filled with spiculated osseous tissue. Final pathology demonstrated active hematopoietic bone marrow filling the sinus.

Methods: We present a case report and literature review of sinonasal EMH.

Results: We identified 14 articles with 15 patients. EMH was typically associated with SCD or beta thalassemia. The average age of presentation was 30. There was a male sex predilection with a ratio of 11:15. The most common presenting symptom was a headache and nasal obstruction (33% for both). The most common finding on CT was a soft tissue expansile mass (73%). The most commonly affected location was the maxillary sinus (60%).

Conclusions: This case report serves as a reminder to consider EMH as an uncommon cause of sinus opacification, particularly in patients with SCD or beta thalassemia. The expansion of hematopoietic tissue may be identified as a sinus mass on CT. By recognizing the potential manifestations of chronic anemia, an accurate and timely diagnosis can be made.

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来源期刊
Allergy & Rhinology
Allergy & Rhinology OTORHINOLARYNGOLOGY-
CiteScore
3.30
自引率
4.50%
发文量
11
审稿时长
15 weeks
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