颈淋巴结结核临床分析

目的探讨颈淋巴结结核的临床特点、诊断及治疗方法。方法回顾性分析2004年10月～2011年5月我院收治的83例颈淋巴结结核患者的临床资料。结果 83例颈淋巴结结核患者,女性多见;肿块位于颈侧中上部30例(36.1%),锁骨上窝32例(38.6%);合并肺结核的12例(14.5%);31例行颈部CT扫描,21例增强扫描表现为肿物环形强化;11例行淋巴结针吸活检,8例确诊,其余3例经淋巴结活检确诊;3例抗结核治疗无效。结论颈淋巴结结核以颈侧部和锁骨上窝肿块为主要表现,部分合并肺结核;颈部增强CT扫描有重要的诊断价值;针吸活检不能确诊的应尽早手术活检;多数患者只需行抗结核治疗,无效者需行手术治疗。     

鼻咽非何杰金型恶性淋巴瘤

在法国,非何杰金型恶性淋巴瘤(LMNH)占鼻咽恶性肿瘤的15％;耳鼻咽喉部LMNH占全部LMNH的20～25％,其中腭扁桃体最多,鼻咽部居第二位。1976年1月～1983年12月Gustare-Roussy研究所共治疗鼻咽LMNH 24例,平均年龄53岁,男:女为2。首发症状为鼻及咽鼓管阻塞者占88％,颈淋巴结肿大者77％,与鼻咽上皮癌相比:颈淋巴结肿大多为双侧性(17例中有10例),且体积较大,为1～16cm(平均5cm);骨质破坏及脑神经侵犯者较少。本组病例经胸片、腹部淋巴造影或CT检查及骨髓穿刺,以了解病变广度,4例EBV血清学检     

鼻咽部结核临床分析并文献复习

目的总结鼻咽部结核的临床特点，为其诊断和治疗提供临床经验。方法回顾性分析2017年10月—2018年2月收治并经组织病理学和TB PCR证实的2例鼻咽部结核患者的临床资料。结果2例患者均经3个月规范抗结核治疗后痊愈，随访1年未复发。结论鼻咽部结核临床比较少见的发病部位，容易被误诊为鼻咽癌。组织病理学检查和TB PCR可以明确诊断，诊断明确后应进行规范的抗结核治疗。     

以持续性耳闷为首发症状的原发性鼻咽结核1例并文献复习

目的：探讨原发性鼻咽结核的临床特点及诊疗方法。方法：报道在我院就诊的1例以持续性耳闷胀感为首发症状的原发性鼻咽结核病例,并对相关文献进行回顾。结果：患者经鼻咽部活检、组织病理学检查,提示结核性肉芽肿伴干酪样坏死,抗酸检测阳性。经抗结核治疗后,患者症状消失,鼻咽部形态基本正常。结论：对于伴有耳部症状的鼻咽部新生物的患者,原发性鼻咽结核应作为鉴别诊断之一,须通过鼻咽部活检组织病理学检测加以明确诊断,以免延误病情。     

颈淋巴结结核临床分析

目的 分析颈淋巴结结核的临床表现及诊治。方法　回顾性分析我院2007～2015年收治100例颈淋巴结结核患者临床资料。结果　纳入患者多以颈部肿块就诊,仅8例伴有低热、盗汗、乏力等全身中毒症状。95例患者经术后病理检查确诊,15例患者术前经细针穿刺确诊。共95例患者接受手术治疗,术后行全身标准抗结核治疗6个月;余 5例患者予以全身标准抗结核治疗,取得满意疗效。手术方式主要有单纯颈淋巴结切除术31例、颈淋巴结清扫术53例和脓肿切开清创术11例,所有患者随访均无复发。结论 颈淋巴结结核的临床表现复杂,细针穿刺活检阳性率不高,术后病理检查有助于进一步明确诊断,外科手术联合术后全身规范抗结核治疗可作为颈淋巴结结核的治疗方法。     

鼻咽癌颈淋巴结转移灶B超检查的临床应用价值

目的　探讨B超检查在鼻咽癌颈淋巴结转移灶检查中的应用价值。方法　对 4 5 1例初发和复发的鼻咽癌病人在放疗前、后均进行颈淋巴结临床触诊和B超检查 ,记录颈淋巴结肿大的有无、大小等情况 ,并进行比较分析。结果　 392例初发病人 ,经B超检查后导致临床分期变化的有 14例 (3.6 % )。触诊双侧颈N0 和单侧颈N0 的假阴性率分别为 2 8.2 %和 2 5 .5 %。鼻咽和颈同时复发的 14例病人中 ,触诊漏诊率为 2 1.4 %。单纯颈复发的32例病人中 ,触诊误诊率为 12 .5 %。在颈淋巴结融合成团的 33例病人中 ,触诊误诊率为 5 1.5 %。在超重或肥胖的31例病人中 ,颈部最大淋巴结的大小触诊与B超检查相比较 ,结果有统计学意义 (P <0 .0 1) ;放疗结束时 ,颈淋巴结全消与残留的情况 ,触诊与B超检查相比较亦有统计学意义 (P <0 .0 0 1)。结论　B超扫描较临床触诊检查鼻咽癌病人颈淋巴结准确性更高 ,对临床分期、指导治疗和判断预后有一定的价值。     

以颈淋巴结肿大为首发表现的鼻咽粘膜下型癌4例报告

目的：加深对以颈上深淋巴结肿大为首发表现的鼻咽粘膜下型癌的认识。方法：报告４例本病患者的临床资料。结果：４例直至发现颈部淋巴结肿大３￣６个月后,才得以确诊为鼻咽粘膜下型癌;均行放疗加化疗,３例在１年内死亡,１例尚生存。结论：对颈上深部淋巴结肿大,首先应考虑为鼻咽粘膜下型癌的转移癌。即使细胞学、ＶＣＡ－ＩｇＡ、ＣＴ、ＭＲＩ、鼻咽部等检查均为阴性,有的甚至已确诊为淋巴结核瘤,但仍不能排除鼻咽粘膜下型癌     

鼻咽部恶性肿瘤放疗的远期疗效

由于局部解剖特点致鼻咽部恶性肿瘤的早期诊断较难,且病理组织学类型大多分化较低、易于复发及转移,故文献报告放疗后五年生存率仅15～40%。本文报导对207例经病理证实的鼻咽部恶性肿瘤放疗后疗效观察。患者男103、女104,年龄由14～70岁,就诊时属Ⅰ～Ⅱ期39名(19%)、Ⅲ期134名(65.6%)、Ⅳ期35名(15.4%)。152名(73.4%)患者有颈淋巴结转移。109例仅接受外照射,98例尚辅以腔内照射。放疗后生存五年以     

鼻咽部结核57例临床诊断分析

鼻咽部结核与鼻咽癌临床鉴别较困难[1] 。为探讨两者鉴别要点 ,我们收集经病理证实的鼻咽部结核 5 7例分析如下。病例分别来自广西医科大学肿瘤医院 2 1例 ,广西医科大学第一附属医院 36例 ;病理证实的鼻咽部结核分别占同期两医院鼻咽部活检人次的 0 84 % (10 /1197)和 1 16 %(36 /3111)。男 2 5例 ,女 32例 ,男女之比为 0 78∶1。年龄 13～ 73岁 ,平均 2 8 7岁 ;其中 10～ 2 0岁占 19例 (占 33 3% ) ,2 1～ 30岁 2 1例 (占 36 9% ) ,31岁以上 17例 (占 2 9 8% )。主要症状为颈部肿块 4 7例 (占 82 5 % ) ,其中 4 3例 (75 4 % )不伴其…     

3168例颈部肿块临床分析

本文复习了10年间经病理确诊的颈部肿块3168例，着重分析其形成病因，以期为临床诊断提供参考。最常见的5种病因依序为甲状腺腺瘤、鼻咽癌颈转移、颈淋巴结结核、慢性淋巴结炎和恶性淋巴瘤．台占总例数的72．8％。在除外甲状腺肿块后的2210例中，恶性肿瘤占首位(53．9%)。故必须十分重视颈部肿块，临诊时应首先排除恶性肿瘤可能，以免误诊、误治。     

Tuberculosis of the nasopharynx: a rare entity revisited

OBJECTIVES: Tuberculosis of the nasopharynx is uncommon. A large series of 17 cases is reported, and the clinical and pathological features are discussed. STUDY DESIGN: A retrospective review. METHODS: Seventeen archived cases of biopsy-proven nasopharyngeal tuberculosis were reviewed for patient age and sex, presenting complaint and duration, systemic symptoms, cervical lymphadenopathy, and chest x-ray findings. These findings were compared with a compilation of 40 cases reported in the English literature. RESULTS: There was a female predominance (13 women and 4 men), with age range of 20 to 74 years (mean age, 38 y). The most common presentation was enlargement of the cervical lymph nodes (53%), followed by hearing loss (12%), tinnitus, otalgia, nasal obstruction, and postnasal drip (6% each). The duration of the presenting symptoms ranged from 1 week to 1 year (mean duration, 16 wk). Ten patients (59%) had cervical lymphadenopathy, two (12%) had systemic symptoms (fever, weight loss, night sweats), and one patient (6%) had miliary pulmonary tuberculosis. Direct endoscopic examination showed nasopharyngeal mucosal irregularity or mass in the majority of patients (12 patients [70%]). These features were similar to those reported in the literature. CONCLUSIONS: Nasopharyngeal tuberculosis is uncommon, usually occurring without pulmonary or systemic involvement. Cervical lymphadenopathy occurs in more than half of the patients and is the most common presenting complaint; this, together with the nasopharyngeal findings of mass or mucosal irregularity, makes differentiation from carcinoma on clinical examination difficult, necessitating histological evaluation.     

Tuberculosis of the nasopharynx: clinicopathological features

The clinicopathological features of 10 adult patients with nasopharyngeal tuberculosis (TB) are presented. 9 patients had no evidence of chest or systemic disease. 7 patients presented with cervical lymphadenopathy, and only 4 had nasal symptoms. Examination of the nasopharynx showed no abnormality in 2 patients, lymphoid hyperplasia in 4 patients, and a tumour-like mass in 4 patients. These findings suggest that nasopharyngeal TB may occur more frequently as part of an isolated upper respiratory tract infection than as secondary to pulmonary infection. The nasopharynx may be a portal of entry for tubercle bacilli in patients who develop cervical lymphadenitis. Involvement of the nasopharynx by TB may be underdiagnosed because it does not produce obvious symptoms or physical signs in all cases.     

Tuberculosis of the nasopharynx: clinicopathological features.

The clinicopathological features of 10 adult patients with nasopharyngeal tuberculosis (TB) are presented. 9 patients had no evidence of chest or systemic disease. 7 patients presented with cervical lymphadenopathy, and only 4 had nasal symptoms. Examination of the nasopharynx showed no abnormality in 2 patients, lymphoid hyperplasia in 4 patients, and a tumour-like mass in 4 patients. These findings suggest that nasopharyngeal TB may occur more frequently as part of an isolated upper respiratory tract infection than as secondary to pulmonary infection. The nasopharynx may be a portal of entry for tubercle bacilli in patients who develop cervical lymphadenitis. Involvement of the nasopharynx by TB may be underdiagnosed because it does not produce obvious symptoms or physical signs in all cases.     

Nasopharyngeal carcinoma presenting as Gradenigo’s syndrome

Nasopharyngeal carcinoma usually has an insidious onset and non-specific features in the initial stages. This makes early diagnosis difficult. The most usual presenting features are cervical lymphadenopathy, otological symptoms (serous otitis media) and involvement of adjacent cranial nerves. We report a case of Gradenigo’s syndrome in a patient of undifferentiated nasopharyngeal carcinoma.     

Nasopharyngeal tuberculosis

Nasopharyngeal tuberculosis is a rare disorder. It usually occurs via hematogenous and lymphatic spread from coexistent pulmonary or systemic tuberculosis, and by airway during respiration or bacillary expectoration. MATERIAL: we present a case of nasopharyngeal tuberculosis in a 50-year-old female patient presenting with a cervical mass and unilateral otitis media with effusion. The diagnosis was made by PCR and by isolation of Mycobacterium Tuberculosis on Loveinstein-Jensen cultures. CONCLUSION: Nasopharyngeal tuberculosis may present with cervical mass, unilateral otitis media with effusion, and may mimic nasopharyngeal carcinoma. Furthermore, nasopharyngeal carcinoma may harbor foci of granulomatous reaction, and this feature may confuse the pathologist. However PCR carries the advantage to detect the DNA of Mycobacterium tuberculosis before its growth on culture. Even though it is rare, this entity must be considered in the differential diagnosis of the nasopharyngeal masses.     

Pseudotumoral mycobacterial infection in the head and neck: a clinical study

The clinical aspects of mycobacterial infection of the head and neck are considered as presenting in patients at a cancer hospital over the last 15 years. Some difficulties in diagnosis with respect to the evolution of tuberculosis in this region are discussed. A total of 32 patients with evidence of infection were identified. Twenty-six of these with cervical lymphadenopathy are considered as a group; their clinical features and diagnosis are summarized and a note made of the recent change in the macroscopic quality of the nodes removed. Six cases are given particular attention: two with laryngeal tuberculosis, two with nasal or adenoidal infection and two with atypical mycobacterial infection diagnosed on clinical grounds.     

鼻咽结核1例并文献复习

目的分析鼻咽结核的临床特点及诊治要点。方法回顾性分析经病理确诊的鼻咽结核1例,并结合相关文献复习。结果患者以颈部无痛性包块为首发症状,经鼻咽部活检、组织病理学检查确诊。通过检索中国知网、万方以及Pubmed数据库中有关鼻咽结核的文献,共检索有关文献32篇,包含患者共194例。结论鼻咽结核临床表现缺乏特异性,易漏诊误诊,临床医生要提高认识,在诊治颈部包块时,应考虑鼻咽结核的可能,尽早反复送病理检查,从而明确诊断。     

妊娠期鼻咽恶性肿瘤临床分析

目的 总结妊娠期合并鼻咽恶性肿瘤患者的临床资料,探讨妊娠期合并鼻咽恶性肿瘤的临床特点,以达到早期诊断、早期治疗的目的。方法 以2007年9月至2012年7月收治的妊娠期合并鼻咽恶性肿瘤5例作为研究对象。其中鼻咽鳞状细胞癌4例,鼻咽恶性肌上皮瘤1例。回顾分析患者的临床表现、诊断结果及治疗情况,并对患者及其子代进行随访。结果 5例患者均为单胎妊娠,3例(60.00%)在妊娠过程中活检确诊后终止妊娠行引产术,2例(40.00%)为妊娠中发病,分别于产后1周和产后1个月活检确诊。新生儿健康存活。鼻咽鳞状细胞癌患者均采用同期放化疗,鼻咽恶性肌上皮瘤患者采用经鼻内镜及软腭联合径路手术治疗,术后1周辅助放疗。结论 妊娠期合并鼻咽恶性肿瘤较为少见,合并鼻咽恶性肌上皮瘤更为罕见。妊娠期由于检查及用药的局限性,容易出现漏诊及误诊。治疗应根据肿瘤性质、分期、患者意愿等因素综合考虑,并对患者及子代做长期随访。     

Primary nasopharyngeal tuberculosis in a patient with the complaint of snoring

Isolated nasopharyngeal tuberculosis is a rare condition, even in endemic tuberculosis areas. The most common presentation of nasopharyngeal tuberculosis is with a cervical lymphadenopathy followed by nasal discharge or obstruction. Here we present a 58-year-old patient with nasopharyngeal tuberculosis whose only complaint was snoring. Her oropharyngeal and anterior rhinoscopic examination was normal. On endoscopic examination, mucosal oedema and hyperaemia of the nasopharynx was observed. There was no cervical lymphadenopathy. The tuberculin skin test was positive and histopathological examination of the biopsy taken from posterior nasopharyngeal wall supported the diagnosis of tuberculosis. After anti-tuberculosis therapy, the snoring stopped and the nasopharyngeal examination was normal.     

咽喉结核34例临床分析

目的:提高临床医生对咽喉结核的认识。方法:回顾性总结我科1995年1月-2001年7月收治的34例咽喉结核患者的临床资料。结果:在病理确诊前仅9例怀疑为结核,其余病例分别被误诊为咽喉部非特异性炎症、恶性肿瘤等。结论:耳鼻咽喉科医生必须充分了解今日咽喉结核的临床特征。对可疑患者应尽早进行病理检查以明确诊断,减少误诊和漏诊。早期确诊和正规抗结核治疗有利于预后。