儿童鼻部肿瘤的临床病理和影像学分析  

The relationship between pathology and imaging overview in pediatric nasal tumors

作　　者：刘金兰[1] 张俐悦 姚东方[1] 李杰恩[1] LIU Jinlan ZHANG Liyue YAO Dongfang LI Jieen(Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, China)

机构地区：[1]广西医科大学第一附属医院耳鼻咽喉头颈外科,南宁530021

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第20期1570-1574,共5页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

摘　　要：目的:加深对儿童鼻部肿瘤的发病情况、临床病理组织学及影像学特点的全面了解,提高临床诊断和鉴别诊断水平。方法:收集经活检或术后病理确诊的40例鼻部肿瘤患儿的资料,总结其临床特征、病理组织学及影像学特点。结果:良性肿瘤23例,恶性肿瘤17例。良性肿瘤以纤维血管瘤(7例)、毛细血管瘤(4例)及骨化纤维瘤(4例)为主;恶性肿瘤以淋巴瘤(10例)及胚胎型横纹肌肉瘤(3例)为主。10例病变主要位于鼻窦,7例病变局限于鼻腔或鼻前庭,8例鼻腔鼻窦均受累,10例病变位于鼻咽部和(或)后鼻孔,3例位于外鼻,2例位于鼻中隔。CT或MRI表现:骨质破坏13例,骨质吸收5例,14例累及邻近结构,6例伴颈部淋巴结肿大。结论:儿童鼻部肿瘤以淋巴瘤、纤维血管瘤、毛细血管瘤、骨化纤维瘤和胚胎型横纹肌肉瘤较常见,其临床症状不典型,诊断及鉴别诊断主要依靠病理及影像学检查,CT和MRI能很好地显示肿瘤的部位、周围骨质改变情况和邻近结构侵犯,对肿瘤的临床诊断、分期、治疗方案的制定及预后评估具有重要意义。Objective： To study the clinical features and nasal image of children with nasal tumors. Metbod：Tbe samples of 40 cases of pediatric nasal tumors, which were diagnosed based on pathology, were collectEd. Clinical features, pathological histology and imaging characteristics were also summarized. Result：There were 23 cases of benign tumors and 17 cases of malignancy. The most common benign tumors were angiofibroma （7 cases）, capil- lary hcmangioma （4 cases） and ossifying fibroma （4 cases）, while the most common malignant tumors were lym- phoma （10 cases） and embryonaI rhabdomyosarcoma （3 cases）. In all cases, 10 tumors arose from sinus, 7 tumors limited in the nasal cavity or nasal vestibule, 8 tumors located in sinonasal, 10 tumors are originated from nasopharyngeal area and （or） postnaris, 3 cases located in the lateral nasal, 2 cases located in the nasal septum. CT or MRI found that 13 cases showed bone destruction, 5 cases showed bone absorption, 14 cases involvement of adjacent structure, 6 cases with cervical lymph node enlargement. Conclusion：The common nasal tumors in cbildren include lymphoma, angiofibroma, capillary hemangioma, ossifying fibroma and emhryonal rhabdomyosarcoma. Clinical manifestations of pediatric nasal tumors were atypical, the diagnosis mainly dependent on patbology and imaging examination. CT and MRI examination can well depict the site of tumors, the bone change of the around situation and the encroachment of the tumor accurately, and may play an important role in clinical diagnosis and staging of the tumors, constituting the treatment plan and prognosis evaluation.

关 键 词：儿奄 鼻宾肿瘤 病理学.临床 体层摄影水.X线计算机 磁共振成像 

分 类 号：R739.62[医药卫生—肿瘤]