木村病4例临床诊断体会

木村病(KD)又称为嗜酸性淋巴肉芽肿(ELG),是一种极其少见的、病因不明、多累及头颈部软组织及浅表淋巴结的慢性肉芽肿性病变.目前报道甚少,多数报道的发生部位均为唾液腺及头颈部软组织与淋巴结.作者曾临床医治4例,其中头颈部3例,腹股沟淋巴结1例.现将其临床表现报道如下,同时结合文献复习,探讨其生物学特性、病理诊断与鉴别诊断.     

木村病4例临床诊断体会

木村病（KD）又称为嗜酸性淋巴肉芽肿（ELG），是一种极其少见的、病因不明、多累及头颈部软组织及浅表淋巴结的慢性肉芽肿性病变。目前报道甚少，多数报道的发生部位均为唾液腺及头颈部软组织与淋巴结。作者曾临床医治4例，其中头颈部3例，腹股沟淋巴结1例。现将其临床表现报道如下，同时结合文献复习，探讨其生物学特性、病理诊断与鉴别诊断。     

颌面部木村病的超声特征

目的: 探讨颌面部木村病的超声声像图表现。方法: 回顾性分析7例颌面部木村病的超声声像图特征。结果: 男性6例,女性1例,年龄18—60岁,病程2个月—15年不等,表现为颌面部慢性无痛性肿块及颈部淋巴结长大,1例出现耳周局部皮肤瘙痒伴色素沉着。5例肿块为单发,分别位于颊部及耳周皮下、颌下腺,1例为右侧颌下腺及腮腺内肿块,1例为双侧腮腺内肿块。6例肿块边界不清楚,形态不规则,伴有嗜酸性粒细胞升高;1例肿块边界清楚,形态规则,嗜酸性粒细胞正常。所有肿块内部均呈不均匀低回声,血流信号为Ⅰ—Ⅲ级。6例肿块周围或颈部伴多发淋巴结长大。结论: 颌面部木村病的超声声像图具有一定特征性,仔细分析其征象并密切结合病史及实验室检查有助于该病的诊断。     

超声误诊颌下腺Mikulicz病1例

病例 男,65岁,以"左颌下肿物"入院.患者2年前发现左颌下肿物,未予以诊治.1月前自觉左颌下异物感,偶感口干,无发热、局部疼痛,无吞咽困难、声音嘶哑,无怕热多汗、烦躁易怒,无眼球压痛、视物模糊等症状.专科查体:左颌下区略肿大,于左颌下可触及一枚肿物,大小约为2.0cmx2.0cm,质韧,无活动,无红肿、压痛,边界尚清...     

左颌下淋巴结木村病1例

患者男,50岁,汉族,已婚,河北省涿州市人,主因左颌下区无痛性肿物发现3个月,于2011年12月12日于我院住院治疗.肿物初发现时约"黄豆"样大小,局部瘙痒,逐渐增至"小枣样"大小,生长过程中亦无疼痛,表面皮肤亦无发红、肿胀.局部瘙痒感较前无明显好转,时常自行小力量搔抓,搔抓过后瘙痒感减轻.无午后低热,饮食及睡眠均正常.患者有烟酒嗜好,烟龄30年,酒龄30年,无家族遗传史.     

木村病的超声特征分析

木村病又称嗜酸性淋巴肉芽肿,以皮下无痛性肿块并周围淋巴结肿大为特征[1],是一种罕见的良性疾病,其发病可能与不明原因的慢性炎症及免疫紊乱有关[2]。目前,关于木村病超声特征的研究报道较少。本组回顾性分析4例木村病患者的临床及超声检查资料,以期提高对本病超声特征的认识。     

木村病5例临床分析

目的：探讨木村病的临床表现、诊断和治疗方法。方法：总结分析5例木村病患者的临床资料。结果与结论：5例均为男性,中位年龄31岁,中位病程7年。表现为头颈部皮下肿物4例,背部皮下肿物1例,伴局部浅表淋巴结肿大4例,腮腺受累2例。外周血嗜酸性粒细胞比例升高4例,血清IgE升高4例,尿蛋白阳性1例。肿物或淋巴结活组织检查均见淋巴组织增生,大量的嗜酸性粒细胞浸润,5例均有淋巴滤泡形成及血管增生,有嗜酸性微脓肿形成2例。临床上对于头颈部无痛性皮下肿物及局部淋巴结肿大的患者,尤其伴有外周血嗜酸性粒细胞及血清IgE升高者,应考虑到木村病的可能,进一步行肿物或淋巴结活组织检查以明确诊断。     

颌面部木村病超声特征、临床特点分析并文献复习

目的 ：探讨颌面部木村病（Kimura disease,KD）的超声特征及临床特点,总结诊断经验。方法 ：对2010年1月—2022年6月山西省肿瘤医院收治的26例KD患者的临床资料及超声图像进行回顾性分析。分析其超声特征及临床特点,并总结诊断经验。结果：本研究共入组KD患者26例,男20例,女6例（性别比3.3∶1）。患者年龄中位数为45岁6月。血常规显示所有患者血清嗜酸性粒细胞的百分比值均增加。超声声像图结果显示26例患者均检出病灶,淋巴瘤可能5例（19.23%）,恶性病灶6例（23.08%）,多形性腺瘤4例（15.38%）,性质待诊建议穿刺活检11例（42.31%）。单纯淋巴结型8例（30.77%）,单纯累及腮腺+周围软组织型11例（42.31%）,同时累及腮腺+周围软组织+淋巴结型7例（26.92%）。对不同类型KD患者病灶的超声特征进行比较,其在边界、形态、混合回声上的差异具有统计学意义（P<0.05）。组织病理学可见淋巴滤泡增生,嗜酸性粒细胞发生浸润,部分生发中心坏死或者形成嗜酸性微脓肿。结论：KD以中青年男性居多,病变多累及头颈部,KD的超声及临床表现容易误诊,应结...     

超声诊断颌下腺淋巴管瘤1例

男,23岁。既往体健,发现右颌下无痛性包块来诊。查体：右颌下可触及明显包块,颈部未触及明显结节。超声检查：右侧颌下腺下极探及一范围约5．1cm×2．3cm×3．8cm的无回声区,壁薄,其内透声好,并可见数条纤细分隔,     

经体表超声及经口腔内超声联合探查诊断下颌下腺结

诊断涎石病的传统方法主要为X线检查、涎腺造影、MR以及临床口底物理检查等。本研究应用经体表超声及经口腔内高频超声联合探查下颌下腺导管结石27例,现报道如下。1资料与方法1.1一般资料收集2007月12月—2011年7月在我院经体表超声及经口腔内高频超声诊断为单侧下颌     

Salivary duct carcinoma of the submandibular gland presenting a diagnostic challenge: A case report

BACKGROUNDSalivary duct carcinoma (SDC) is a rare, extremely aggressive malignancy that arises in the submandibular gland. It can metastasize locally early and therefore is an important differential diagnosis of metastatic disease in cervical lymph nodes or specific lymphadenitis such as tuberculous cervical lymphadenitis.CASE SUMMARYWe report a case of SDC in the submandibular gland that presented diagnostic difficulty. The lesion was coincidentally discovered through examination of the radiolucent area of the maxilla. Imaging failed to confirm the possibility of specific inflammation, leading us to execute an open biopsy to verify the diagnosis. The surgical specimen showed that the submandibular gland was primarily replaced with a calcified body. Following histological analysis and confirmation, we performed surgical resection, radiotherapy, and various chemotherapies. CONCLUSIONRadiographic imaging characteristics of lymph node metastases of salivary gland cancer, especially of SDC, may resemble other cervical lymphadenitis; calcification at the submandibular gland is the landmark of SDC occurring at the subman-dibular gland.     

Sclerosing polycystic adenosis of the submandibular gland: Two case reports

BACKGROUNDSclerosing polycystic adenosis (SPA) is a rare disease of salivary glands, similar to fibrocystic disease of the breast. It occurs over a wide age range and exhibits a slight female preference. Most SPA cases have occurred in the parotid gland. The exact nature of SPA is unclear, but its tumor nature has recently been proposed. Although SPA has a good prognosis after adequate surgery, atypical lesions might occur, ranging from mild dysplasia to carcinoma in situ in some cases. To the best of our knowledge, only five cases of SPA in the submandibular gland have been reported to date. Here, we present two new cases of SPA involving the submandibular gland.CASE SUMMARYA 50-year-old woman and a 52-year-old woman were referred to Tongji Hospital in Wuhan, China, with complaints of moderate pain, recurrent swelling, and a mass in the submandibular area. After admission, the two cases of the submandibular mass were examined physically. The boundary of the submandibular tumor was clear, and the range of motion was good. After preoperative examinations, surgery was performed on a selective basis. Postoperative histopathological examination revealed a well-defined mass with acinar structures, ducts, or cystic dilated glands of various sizes scattered in a large number of proliferative sclerosing stroma. There were flat and cuboidal cells, and eosinophils in the duct epithelium. There was also a eosinophilic substance in the lumen of dilated cysts. No atypical epithelial hyperplasia, invasive growth, or carcinoma in situ was found. Based on the above findings, the mass was diagnosed as SPA. Both patients have remained asymptomatic and no recurrence or distant metastasis had occurred by the 7-mo and 5-year follow-up, respectively.CONCLUSIONSPA is a rare disease of the salivary gland. Even though it has a good prognosis after adequate surgery, atypical lesions may occur from mild dysplasia to carcinoma in situ. However, no recurrence, distant metastasis, or mortality has been reported for submandibular gland SPA. Clinicians and pathologists should be familiar with the characteristics of SPA in the submandibular gland to avoid misdiagnosis and overtreatment.     

上肢木村病一例

患者男,19岁。发现右上肢肿物4个月,肿物持续增大1个月。查体:右上臂远端可见约5 cm×8 cm肿物,无压痛,质硬,活动度差,皮肤可见暗纹,皮温正常,皮色可。实验室检查:外周血嗜酸性粒细胞百分比43.34%(参考范围:0.40%~8.00%),嗜酸性粒细胞6.14×10^9/L(参考范围:0.02~0.52×10^9/L),血清免疫球蛋白IgE 15100.00 IU/ml(参考范围:0~100 IU/ml)。骨髓穿刺提示嗜酸性粒细胞增多。     

彩色多普勒超声在颌下腺导管结石检查治疗中的应用

目的探讨涎石症患者颌下腺导管内结石的分布及其颌下腺超声表现。方法术前对33位患者颌下腺导管进行分区,应用彩色多普勒超声确定颌下腺导管结石位置及颌下腺腺体的超声表现,行手术及内镜术取石治疗,超声诊断结果与手术观察对照分析。结果33例患者中检出颌下腺导管前段结石12例,后段结石19例,分支导管内仅检出结石2例,手术和内镜术取石结果与术前超声提示诊断结果相符。结论颌下腺导管结石好发于导管后段,分支导管结石较少见,超声诊断颌下腺导管结石的准确性高,在确定结石位置、数量,观察导管扩张及颌下腺感染程度均有重要作用,可为涎石病诊断及手术治疗提供重要依据。