Syms M J, Birkmire-Peters D P, Holtel M R
House Ear Institute and House Ear Clinic, Los Angeles, California 90057, USA.
Laryngoscope. 2000 Nov;110(11):1807-10. doi: 10.1097/00005537-200011000-00006.
To determine the incidence of malignancy in patients with incidentally discovered unilateral tonsillar enlargement with an otherwise normal physical examination.
A retrospective review of our institution's experience with unilateral tonsillar enlargement.
During a five-year period, 570 patients underwent tonsillectomy at our institution. Of patients undergoing tonsillectomy, 49 patients (8.6%) underwent tonsillectomy with normal mucosa, no lymphadenopathy, and asymmetry of the tonsils. Two (4.8%) of the 49 patients with unilateral enlargement had the presence of malignancy. The two adult patients had B-cell lymphoma. Of all of the patients undergoing tonsillectomy, 0.35% had occult malignancy. In additional, the ability of the clinically assessed size (1+, 2+, 3+, and 4+) to predict volume was evaluated. The clinically assessed size and pathologically measured volume were significantly correlated (R = 0.333, P < .013). In 60.5% of the patients, the clinically assessed size and the pathologically measured volume agreed with the asymmetry reported on physical examination.
A relatively high number of tonsillectomies will be performed to yield an approximately 5% positive rate of malignancy within removed tonsils that are asymmetrical with normal mucosa and no cervical adenopathy.
确定在体格检查其他方面正常但偶然发现单侧扁桃体肿大的患者中恶性肿瘤的发生率。
对本机构单侧扁桃体肿大患者的经验进行回顾性分析。
在五年期间，本机构有570例患者接受了扁桃体切除术。在接受扁桃体切除术的患者中，49例（8.6%）在黏膜正常、无淋巴结病且扁桃体不对称的情况下接受了扁桃体切除术。49例单侧肿大患者中有2例（4.8%）存在恶性肿瘤。这两名成年患者患有B细胞淋巴瘤。在所有接受扁桃体切除术的患者中，0.35%患有隐匿性恶性肿瘤。此外，还评估了临床评估大小（1+、2+、3+和4+）预测体积的能力。临床评估大小与病理测量体积显著相关（R = 0.333，P <.013）。在60.5%的患者中，临床评估大小和病理测量体积与体格检查报告的不对称情况相符。
将进行相对较多的扁桃体切除术，以使切除的扁桃体中黏膜正常且无颈部淋巴结病但不对称的恶性肿瘤阳性率约为5%。
