Sezer Bahar, Tugsel Zuhal, Bilgen Cem
Ege University, School of Dentistry, Department of Oral and Maxillofacial Surgery, Bornova 35100, Izmir, Turkey.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003 Apr;95(4):471-3. doi: 10.1067/moe.2003.65.
A case of a large tonsillolith of the left palatine is presented. The lesion was detected incidentally during radiographic examination of a patient presenting with right mandibular pericoronitis. The patient had no symptoms referable to the left tonsillar region. Superimposition of the tonsillolith on the left mandibular ramus on panoramic radiographic examination created the false impression of an intraosseous radiopaque lesion. Many radiopaque structures and lesions occur in the soft tissues close to the jaws and are often observed on panoramic radiographs produced by imaging units with broad focal troughs. Such radiopacities in the mandibular molar-ramus region include sialolith, phlebolith, cysticercosis and calcified lymph node, carotid artery arteriosclerosis, stylohyoid ligament mineralization, and dystrophic calcification in acne scars. Tonsilloliths may present on panoramic radiograph as radiopaque objects superimposed on the midportion of the ascending mandibular ramus, and may be initially misinterpreted as intraosseous lesions of the mandible, such as foreign body, odontoma, sclerosing osteitis, Garre osteomyelitis, fibrous dysplasia, idiopathic osteosclerosis, and osteoma.
本文报告一例左侧腭扁桃体巨大扁桃体结石病例。该病变是在对一名患有右下颌智齿冠周炎的患者进行影像学检查时偶然发现的。患者左侧扁桃体区域无相关症状。全景X线检查时，扁桃体结石叠加在左侧下颌升支上，造成了骨内不透光病变的假象。许多不透光结构和病变出现在颌骨附近的软组织中，并且经常在具有宽焦槽的成像设备所产生的全景X线片上观察到。下颌磨牙-升支区域的此类不透光影像包括涎石、静脉石、囊尾蚴病和钙化淋巴结、颈动脉粥样硬化、茎突舌骨韧带矿化以及痤疮瘢痕中的营养不良性钙化。扁桃体结石在全景X线片上可能表现为叠加在下颌升支中部的不透光物体，最初可能被误诊为下颌骨的骨内病变，如异物、牙瘤、硬化性骨炎、Garre骨髓炎、骨纤维异常增殖症、特发性骨硬化和骨瘤。
