30例原发性扁桃体恶性肿瘤的发病特征分析

目的 总结30例原发性扁桃体恶性肿瘤患者的发病特征.方法 30例原发性扁桃体恶性肿瘤患者,回顾性分析患者的一般资料、首发症状、就诊经过、局部查体、病理类型等.结果 30例患者中,男20例,女10例;年龄33～79岁,平均年龄(58.2±11.6)岁;有吸烟史20例,吸烟时间10～50年,平均吸烟时间(30.3±11.2...

Characteristics of 30 patients with primary tonsillar malignances

Objective To summarize the characteristics of 30 patients with primary tonsillar malignances.Methods The general information,first symptoms,medical history,local physical examination,pathological type of 30 patients with primary tonsillar malignances was retrospectively analyzed.Results Among the 30 patients,there were 20 males and 10 females;aged 33-79 years,with an average age of(58.2±11.6)years;20 patients with a history of smoking,smoking for 10 to 50 years,and an average of(30.3±11.2)years.Among smokers,there were 19 males and 1 female.2 cases were asymptomatic and were found by physical examination;the remaining 28 patients had first symptoms of pharyngeal pain(salgia/swallowing)in 10 cases,pharyngeal foreign body sensation in 10 cases,and neck mass in 8 cases.The course of disease ranged from 0.5 to 120.0 months,with an average duration of(7.9±22.2)months.Among them,15 cases had a history of antibiotic application during treatment,and 4 cases had different degrees of improvement in symptoms.Local examination showed asymmetric tonsillar enlargement in 17 cases,ulcerative type in 5 cases and vegetable like tumor in 8 cases.The tonsils or tonsil masses of all patients were obviously hard on palpation,and the ulcer type was mostly tender,accounting for 80%(4/5).The total white blood cell count of all patients was in the normal range.Among the 30 patients,19 cases(63%)were squamous cell carcinoma and 11 cases(37%)were lymphoma.For the degree of differentiation of tonsil squamous cell carcinoma,there was 3 cases of high differentiation(16%,3/19),and 16 cases of medium/low differentiation(84%,16/19).Among tonsil lymphomas,8 cases were diffuse large B-cell lymphoma(73%,8/11),2 cases were peripheral T-cell lymphoma(18%,2/11),1 case was small lymphocytic lymphoma(9%,1/11).Conclusion Tonsillar palpation plays an important role in the diagnosis.Routine tonsil palpation is recommended in the following situations:①Sore throat lasts for more than half a month,or pharyngeal foreign body sensation lasts for more than 2 months,physical examination reveals asymmetric tonsillar enlargement,blood routine is normal;②Neck mass is the first symptom,physical examination revealed asymmetric tonsillar enlargement.