原发性扁桃体恶性肿瘤误诊、诊断及鉴别诊断探讨  

Diagnosis,misdiagnosis and differential diagnosis of primary malignant tumors of the tonsil

作　　者：成伟[1] 陈健智 

机构地区：[1]南方医科大学附属南海医院耳鼻咽喉科,广东佛山528200 [2]南方医科大学附属南海医院病理科,广东佛山528200

出　　处：《山东大学耳鼻喉眼学报》2012年第3期61-62,67,共3页Journal of Otolaryngology and Ophthalmology of Shandong University

摘　　要：目的探讨原发性扁桃体恶性肿瘤的诊断及鉴别诊断、临床和病理误诊的原因与避免误诊的措施。方法回顾性分析了2000～2007年原发于扁桃体的恶性肿瘤24例患者资料。结果鳞状细胞癌8例,扁桃体非霍奇金淋巴瘤(NHL)15例,10例为B细胞来源,5例为T细胞来源;扁桃体霍奇金淋巴瘤(HL)1例;延迟诊断8例,及时诊断16例。结论扁桃体恶性肿瘤临床特征缺乏特异性,病理表现复杂,适当取材和依据病理及免疫组化尽早确诊是重要的。医师对该病认识不足是导致误诊的主要原因,而及时活检、详细的病史采集及全面的检查有助于减少误诊。扁桃体切除术有利于扁桃体恶性肿瘤的早期诊断及治疗。Objective To investigate the diagnosis, differential diagnosis, cause of clinical and pathological misdiag- nosis of primary malignant tumor of the tonsil and measures against the misdiagnosis. Methods 24 cases with ma- lignant tumor of the palatine tonsil from 2000 to 2007 were retrospectively analyzed. Results Pathological types of the malignancy consisted of 8 squamous cell carcinoma（SCC）, 15 non-Hodgkin＇s lymphoma （NHL, including 10 cases from B-cell and 5 cases from T-cell）, and 1 Hodgkin＇s lymphoma （HL）. Delayed diagnosis was reached in 8 patients（33.33% ）. Conclusion Patients with primary malignant tumor of the tonsil lack characteristic clinical symp- toms. Pathological manifestation is complicated. It is important to perform early biopsy followed by immunohistochem- ical tests. The main causes of misdiagnosis are nonspecific clinical symptoms and doctors＇ lack of awareness. Timely biopsy and detailed history/physical examination are helpful to reduce the misdiagnosis, as well as tonsillectomy.

关 键 词：扁桃体 恶性肿瘤 诊断 误诊 鉴别诊断 

分 类 号：R739.6[医药卫生—肿瘤]