鼻腔呼吸上皮腺瘤样错构瘤临床和病理特征分析  

Analysis of clinical and pathological features of respiratory adenomatoid epithelial hamartoma in nasal cavity

作　　者：许庆庆 张媛[1] 段甦[1] 佘文煜[1] 王向东[2,3] 张罗[1,2,3] XU Qingqing;ZHANG Yuan;DUAN Su;SHE Wenyu;WANG Xiangdong;ZHANG Luo(Department of Allergy,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing,100730,China;Beijing InstituteofOtolaryngology,Bejing,100005,China)

机构地区：[1]首都医科大学附属北京同仁医院鼻过敏科,北京100730 [2]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [3]北京市耳鼻咽喉科研究所,北京100005

出　　处：《中国耳鼻咽喉头颈外科》2022年第8期507-510,共4页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：教育部长江学者创新团队(IRT13082);国家自然科学基金(82171110);北京市自然科学基金(7222024);中国医学科学院医学与健康科技创新工程项目资助(2019-I2M-5-022);北京市科技计划首都健康保障培育研究项目(Z181100001618002);北京同仁医院院内基金(2018-YJJ-ZZL-001)。

摘　　要：目的 分析发生于鼻腔的呼吸上皮腺瘤样错构瘤(respiratory epithelial adenomatoid hamartoma,REAH)临床和病理特征。方法 回顾性分析2014年9月~2021年11月首都医科大学附属北京同仁医院鼻过敏科收治的24例鼻腔REAH患者的临床资料,分析其视觉模拟量表(VAS)评分、鼻内镜检查Lund-Kennedy(L-K)评分、鼻窦CT影像Lund-Mackay(L-M)评分以及病理特征。结果 VAS评分以鼻塞和嗅觉得分最高,均为6分;L-K评分以鼻息肉和嗅裂(olfactory cleft,OC)阻塞为主;L-M评分总分8.75,筛窦、窦口鼻道复合体、OC得分较高。24例患者鼻窦CT冠状位OC宽度(10.5±1.5)mm,水平位(11.5±1.5)mm。病理结果显示发生于鼻腔REAH常与鼻息肉同时存在。结论 发生于鼻腔的REAH常与鼻息肉同时存在,症状、内镜以及影像学诊断缺乏特异性,确诊主要依靠病理学。REAH是否可以定义为错构瘤、炎症反应过程或肿瘤性病变仍有待确定。OBJECTIVE To analyze the clinical and pathological features of respiratory adenomatoid epithelial hamartoma(REAH) in nasal cavity.METHODS Theclinical data of 24 patients with nasal reah treated in Department of Allergy,Beijing Tongren Hospital,Capital Medical University,from September 2014 to November 2021 were analyzed retrospectively.The visual analogue scale(VAS),nasal endoscopy score(Lund Kennedy,L-K),computed tomography score(Lund Mackay scoring system,L-M) and pathological characteristics were analyzed.RESULTS The scores of nasal obstruction and smell were the highest in VAS,both of which were 6 points;L-K was mainly blocked by nasal polyps and olfactory cleft(OC);The total score of L-M was 8.75,and the scores of ethmoid sinus,ostiomeatal complex and OC were higher.The width of olfactory fissure on coronal CT in 24 patients was (10.5±1.5)mm;The horizontal position is (11.5±1.5)mm.Pathology showed that reah occurred in the nasal cavity and often coexisted with nasal polyps.CONCLUSION REAH occurring in nasal cavity often coexists with nasal polyps.The diagnosis of symptoms,endoscopy and imaging lacks specificity.The diagnosis mainly depends on pathology.Whether reah can be defined as hamartoma,inflammatory process or neoplastic lesion remains to be determined.

关 键 词：鼻腔 病理学 呼吸上皮腺瘤样错构瘤 诊断 

分 类 号：R739.62[医药卫生—肿瘤]