结内结外型并发淋巴瘤误诊为牙龈癌转移1例  

Concurrent nodal and extranodal lymphoma misdiagnosed as metastatic gingival carcinoma: A case report

作　　者：周武 黄谢山[1] 韩静欣 王子佳[1] ZHOU Wu, HUANG Xieshan, HAN Jingxin, WANG Zijia(Department of Oral and Maxillofacial Surgery, Affiliated Haikou Hospital of Xiangya School of Medicine, Central South University; Hainan Provincial Stomatology Center, Hailcou 570208j Chin)

机构地区：[1]中南大学湘雅医学院附属海口医院,海南省口腔医学中心口腔颌面外科,海口570208

出　　处：《中南大学学报（医学版）》2018年第3期337-340,共4页Journal of Central South University ：Medical Science

摘　　要：恶性淋巴瘤的早期诊断往往比较困难,发生于颌面部的淋巴瘤的临床表现与鳞癌非常相似,当病理诊断不明确时容易使医生误判而导致误治。本例患者以牙龈肿块伴同侧颌下肿大就诊,其临床表现及术前MRI均非常倾向于鳞癌伴转移,故未行术前病理检查。术中先行切除牙龈肿块,术中冰冻切片的病理报告为恶性小圆细胞瘤,考虑到小圆细胞瘤恶性程度高,且颌下区已有明显转移灶,故行龈颌颈联合根治术。术后病理报告为恶性淋巴瘤,遂知误诊误治该患者,本文分析误诊原因并寻找改进措施。Early diagnosis of malignant lymphoma is often difficult since the clinical manifestation of the lymphoma occurred in the maxillofacial region is very similar to that of the squamous cell carcinoma. When the pathological diagnosis is not clear, the surgeon is easy to misdiagnose and lead to mistreatment. A patient visited the Affiliated Haikou Hospital of Xiangya School of Medicine. Central South Universily for gingival mass with an ipsilateral submaxillary enlargement. The clinical manifestation and preoperative MRI are very prone to squamous ce^l carcinoma with metastasis, so we did not take a preoperative pathological examination. The gingival mass was surgical removed firstly, but frozen pathological result showed that it was malignant small round cell tumor. Since the patient was diagnosed as high degree malignant of small round cell tumor and the submandibular region have been significantly metastasized, so we carried out the combined radical dissection of gingival, mandible and neck surgery. The postoperative pathological report was malignant lymphoma, suggesting that the patient was a case of misdiagnosis and mistreatment. This article draws lessons from misdiagnosis and provided experience for seeking improvement measures.

关 键 词：牙龈淋巴瘤 误诊 结内结外型淋巴瘤 牙龈癌转移 

分 类 号：R733.1[医药卫生—肿瘤]