鼻腔呼吸道上皮腺瘤样错构瘤一例

患者女,49岁,因双侧鼻塞,流涕2年于2009年1月入院.患者于2年前开始无明显诱因出现双侧鼻塞,渐进性加重,经常流黏液样鼻涕,偶有头面部胀痛、晨起鼻痒及打喷嚏.     

鼻腔呼吸道上皮腺瘤样错构瘤

目的　分析19例鼻腔呼吸道上皮腺瘤样错构瘤（respiratory epithelial adenomatoid hamartoma,REAH）的临床特点。方法　回顾性分析我科经病理证实的19例鼻腔REAH,分析其临床、影像及病理学资料。结果　19例患者临床症状与慢性鼻窦炎及鼻息肉症状相似,其中8例有鼻内镜手术史。17例患者新生物位于双侧嗅区,2例位于鼻中隔。17例鼻窦CT示双侧鼻腔嗅区可见软组织呈膨胀性生长,鼻窦内可见不同程度的炎症表现,2例鼻窦CT示鼻中隔孤立肿物。结论　REAH的临床症状缺乏特异性,但该病并不少见,因其有独特的影像学及病理表现,所以临床医师应充分认识该病并术中取材准确,可以提高其诊断率及治愈率,降低术后复发。     

鼻腔呼吸上皮腺瘤样错构瘤临床和病理特征分析

目的　分析发生于鼻腔的呼吸上皮腺瘤样错构瘤（respiratory epithelial adenomatoid hamartoma,REAH）临床和病理特征。方法　回顾性分析2014年9月～2021年11月首都医科大学附属北京同仁医院鼻过敏科收治的24例鼻腔REAH患者的临床资料,分析其视觉模拟量表（VAS）评分、鼻内镜检查Lund-Kennedy（L-K）评分、鼻窦CT影像Lund-Mackay（L-M）评分以及病理特征。结果　VAS评分以鼻塞和嗅觉得分最高,均为6分;L-K评分以鼻息肉和嗅裂（olfactory cleft,OC）阻塞为主;L-M评分总分8.75,筛窦、窦口鼻道复合体、OC得分较高。24例患者鼻窦CT冠状位OC宽度（10.5±1.5）mm,水平位（11.5±1.5）mm。病理结果显示发生于鼻腔REAH常与鼻息肉同时存在。结论　发生于鼻腔的REAH常与鼻息肉同时存在,症状、内镜以及影像学诊断缺乏特异性,确诊主要依靠病理学。REAH是否可以定义为错构瘤、炎症反应过程或肿瘤性病变仍有待确定。     

鼻腔呼吸道上皮腺瘤样错构瘤1例并文献复习

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。     

鼻腔呼吸道上皮腺瘤样错构瘤临床和影像学分析

目的　分析鼻腔呼吸道上皮腺瘤样错构瘤的临床和影像学特点。方法　回顾性分析北京同仁医院鼻科经病理证实的98例鼻腔呼吸道上皮腺瘤样错构瘤患者的临床和影像学资料,分析其临床、影像及病理学特征。结果  98例患者中,男72例,女26例,平均年龄48.60岁。临床症状与慢性鼻窦炎及鼻息肉症状相似,81例新生物位于嗅裂区, 9例位于鼻中隔,8例位于鼻咽部。98例鼻窦CT或MRI显示鼻腔软组织呈膨胀性生长,鼻窦内可见不同程度的炎症表现。所有患者行鼻内镜下病变切除,2例复发。结论　鼻腔呼吸道上皮腺瘤样错构瘤的临床症状缺乏特异性,好发部位为嗅裂区,有独特的病理学表现,手术彻底切除病变能有效控制术后复发。     

鼻腔上皮样血管内皮瘤一例

患者男,54岁,主因右侧鼻塞、伴间断性涕中带血半个月于2010年10月入院.患者半个月前无明显诱因出现反复右侧鼻塞、异物感,伴间断涕中带血,无嗅觉减退、鼻痒、打喷嚏、流清涕.外院检查发现右侧鼻腔肿物,拟行门诊局麻手术治疗时右鼻腔出血量较多,手术未能进行,遂来我院就诊.患者平素身体健康.查体:一般情况良好,自主体位,查体合作,心肺腹未见明显异常.专科检查右侧鼻腔可见一肿物,呈紫红色,堵塞右侧中鼻道、总鼻道,肿物质软,表面欠光滑,触之易出血,无明显触痛.鼻窦CT示各鼻窦窦壁骨质结构完整,右侧鼻腔内略高密度影,占据右侧中鼻道及下鼻道,右侧下鼻甲部分骨质结构欠规整(图1).入院后第3天全身麻醉下行右侧鼻腔肿物切除术.术中以1％利多卡因及0.1％盐酸肾上腺素棉片收缩鼻腔黏膜后,见右侧总鼻道一暗紫色新生物,表面不平,有部分灰白色坏死样组织附着,探查肿物基底位于右侧中鼻甲偏内侧,右侧下鼻甲形态未见异常,黏膜光滑完整,但被挤压贴近鼻腔外侧壁,下鼻道狭窄.手术完整切除肿物及肿物周缘部分正常黏膜,术中见右侧中鼻甲骨质无破坏,右侧中鼻甲创面以电刀均匀烧灼一遍.切除肿物标本大体所见:肿物呈暗紫色,不规则形,表面不光滑,实性,有弹性,剖面略呈灰红色.     

鼻腔上皮样血管内皮瘤一例

患者女,48岁,因右侧鼻腔反复出血伴鼻塞3个月于2015年1月入院。患者入院前3个月无明显诱因出现反复右侧鼻腔出血,伴右侧鼻塞,嗅觉稍减退,无鼻痒、打喷嚏、流清涕。患者既往体健。查体：神志清楚,自主体位,查体合作,心肺腹未见明显异常。专科检查见右侧鼻腔一肿物堵塞右侧中鼻道、总鼻道,呈暗红色,质软,表面凹凸不平,     

呼吸道上皮腺瘤样错构瘤

呼吸道上皮腺瘤样错构瘤（respiratory epithelial adenomatoid hamartoma,REAH）是一种非常少见的良性鼻腔鼻窦疾病。我们的课题组首先在国内报道该病,并多次报道该疾病,并且围绕REAH进行一系列研究及探讨。REAH并非罕见疾病,对该疾病的认识增加可提高该病的诊断率。现就REAH的病因、免疫学标记、诊断及治疗做一综述。     

鼻腔错构瘤1例

错构瘤常发生于腋窝、上臂及肩胛部 ,发生在头面部 ,尤其鼻腔较少见。我科曾收治 1例鼻腔错构瘤患者 ,经手术治疗后恢复较好。患者 ,女 ,2 3岁。 1 996年起于感冒后出现左鼻通气不畅 ,随着病程延长 ,鼻塞逐渐加重 ,1年前于私人诊所行左鼻甲封闭治疗 ,鼻塞减轻。但近半年又加重 ,且出现右侧鼻塞 ,伴脓性涕 ,张口呼吸 ,持续性头痛。以“双上颌窦炎”于 1 999年 5月 2 8日收治入院。检查 :一般情况好。鼻内窥镜下见左鼻腔有较多脓涕 ,清除后于左鼻腔外侧壁、中鼻甲与下鼻甲之间有一带蒂状肿物向后鼻孔、鼻咽部脱出。肿物表面被覆脓性分泌物 ,清…     

Chondro-osseous respiratory epithelial adenomatoid hamartoma of the nasal cavity: a case report

Chondro-osseous respiratory epithelial adenomatoid hamartoma (COREAH) of the nasal cavity is an exceedingly rare benign lesion of the nasal cavity. We report a case arising in an 11-year-old male patient, who presented with a 6-month history of right-sided nasal obstruction. Examination revealed a large fleshy, tender polyp in the right nasal cavity. Computed tomography (CT) and magnetic resonance imaging (MRI) confirmed the large mass in the anterior nasal cavity extending superiorly to the cribriform plate on the right hand side. The polyp was resected endoscopically and confirmed histologically as a COREAH. The clinical differential diagnosis includes cartilaginous tumours and other hamartomatous lesions. Local resection should be curative.     

Respiratory epithelial adenomatoid hamartoma in the nasal cavity

We report a 65-year-old male with a hamartoma in the left nasal cavity. A mass was found in the left nasal cavity and was diagnosed as a benign tumor on the basis of preoperative findings. Left lateral rhinotomy was performed to completely remove it and the lesion was found to have arisen from the inferior turbinate. The pathological diagnosis was respiratory epithelial adenomatoid hamartoma. We discuss the pathological features of this disease.     

A case of respiratory epithelial adenomatoid hamartoma

We report a case of a 70-year-old man diagnosed with a respiratory epithelial adenomatoid hamartoma (REAH) of the nasal cavity after a past sinus surgery and associated with nasal polyposis. REAH is a recently described pathologic entity that can present with nasal obstruction, congestion, rhinorrhea, epistaxis, hyposmia, and headaches. It is a rare lesion of nasal and paranasal sinuses, but should be considered in the differential diagnosis because it is a benign lesion and complete surgical resection is curative.     

Rare case of a respiratory epithelial adenomatoid hamartoma of the nasal cavity, maxillary sinus et ethmoid sinuses: a clinicopathologic study

A case of the respiratory epithelial adenomatoid hamartoma of the nasal cavity, maxillary sinus and ethmoid sinuses for the first time in the polish literature was reported. Characteristic clinical symptoms and histopathologic features, diagnosis and surgical intervention as well differential diagnosis were introduced.     

Respiratory epithelial adenomatoid hamartoma associated with nasal polyposis

Hamartoma is a rare, non-neoplastic tumor characterized by an abnormal mixture of tissues, which are indigenous to the region. They are rare in the nasal cavity. We report a 79-year-old woman with an adenomatoid hamartoma in the left nasal cavity associated with nasal polyposis. This association supports the hypothesis that inflammation is one of the factors that induce the development of a hamartoma. Functional endoscopic sinus surgery was performed to completely remove it, and this lesion was found to have arisen from the lateral nasal wall. It is an unusual localization because the most common site in the nasal cavity is the nasal septum, particularly the posterior aspect. Limited but complete surgical resection is the treatment of choice. Although adenomatoid hamartoma arising from the sinonasal tract is very rare, head and neck surgeons should be aware of this pathological entity as a differential diagnosis for inverted papilloma and adenocarcinoma. Misinterpretation of these lesions as a true neoplasm may result in unnecessarily aggressive surgery for this benign lesion.     

Respiratory epithelial adenomatoid hamartoma associated with inflammatory nasal polyposis: a case report

Respiratory epithelial adenomatoid hamartoma (REAH) is an uncommon benign lesion of the nasal cavity and paranasal sinuses. The etiology is unclear, however it is considered to be secondary to chronic sinonasal inflammation. Although it is rare, REAH should be taken into consideration in differential diagnosis of the nasal lesions. Complete surgical excision of the lesion is generally enough for the cure. A detailed pathological examination is necessary to prevent unnecessary surgical interventions. In this article, we present a 60-year-old female patient with REAH in the left nasal cavity associated with inflammatory polyp in the right nasal cavity.