摘要
1病例报告
例1男,57岁,因咽痛3个月于2015年5月10日入院。外院诊断为咽部溃疡,予阿莫西林、地塞米松口服后无好转。否认肺结核病史。电子喉镜检查：鼻咽顶后壁见弥漫性黄白色假膜形成,蔓延至软腭,表面见污秽状分泌物（图1）。实验室检查：血沉、超敏C反应蛋白、降钙素原、白细胞及免疫球蛋白均升高。鼻咽和颈部MR：鼻咽部黏膜轻度弥漫增厚,增强扫描均匀强化（图2）,左侧颈部见多发肿大淋巴结影。
Nasopharyngeal tuberculosis is a noteworthy disease and it should be differentiated from with nasopharyngeal carcinoma（NPC）,especially in southern China,because of both having similar clinical presentations such as cervical lymph node enlargement and lesions in nasopharynx.Here we report 2 middle-aged patients of nasopharyngeal tuberculosis;between them,one was male,another was female.They came to hospital with the symptoms of pharyngeal pain and neck node,respectively.The former patient was accompanied by repeated fever.His chest radiographic displayed suspected active lesions;and nasopharyngeal examination inspected irregular mucosa with white patch covering the nasopharyngeal area;and magnetic resonance imaging（MRI）presented diffuse thickening of the mucosal wall of nasopharynx;moreover,the biopsy specimen pathological results showed ulceration with mucosal squamous papillary hyperplasia.Finally,acid-fast staining of nasopharyngeal secretions disclosed acid-fast bacilli was positive.However,the latter patient was completely different from the former in clinical presentations,while MRI finding was almost the same.In addition,the endoscopy depicted that characteristic of nasopharyngeal lesion was smooth,congested and swelling,and the pathological result revealed granulomatous inflammation with epithelioid histiocytes and multinucleated giant cells of Langerhans type.Combined their clinical manifestations with various laboratory and imaging examinations,both of the two patients were eventually diagnosed as nasopharyngeal tuberculosis.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
北大核心
2018年第8期624-626,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
鼻咽结核
结核分枝杆菌
人免疫缺陷病毒
鼻咽肿瘤
误诊
nasopharyngeal tuberculosis
mycobacterium tuberculosis
human immunodeficiency virus
naso-pharyngeal neoplasms
diagnostic errors
