Shimada Akiko, Oshita Yuichi, Kinoshita Takashi, Rikimaru Toru, Aizawa Hisamichi
First Department of Internal Medicine, Kurume University School of Medicine, 67 Asahimachi, Kurume-shi, Fukuoka 830-0011, Japan.
Kekkaku. 2003 Dec;78(12):751-5.
Although the prevalence of nasopharyngeal tuberculosis has decreased after the wide use of anti-tuberculous agents, recently the number of reports with the disease has slightly increased in accordance with advances in the diagnostic tools. A case of nasopharyngeal tuberculosis without any tuberculous lesions in other organs (primary nasopharyngeal tuberculosis) was reported.
A 74-year-old female complained of vertigo and cervical masses, and naso-pharygo-laryngoscopy disclosed a polypoid lesion on her nasopharynx. The biopsy from the mass revealed epithelioid cell granulomas with caseous necrosis and multinucleated giant cells consistent with tuberculosis. Since there were no tuberculous lesions in other organs except cervical lymph nodes in clinical examinations, we diagnosed the case as primary nasopharyngeal tuberculosis with tuberculous cervical lymphadenitis. The nasopharyngeal manifestation disappeared after four months chemotherapy with INH, RFP and EB.
Most reported case of nasopharyngeal tuberculosis were in the young age group. A rare case of old woman complicated with cervical tuberculous lymphadenitis was reported.
尽管在广泛使用抗结核药物后，鼻咽结核的患病率有所下降，但近年来，随着诊断工具的进步，该病的报告数量略有增加。本文报告了一例在其他器官无任何结核病变的鼻咽结核（原发性鼻咽结核）病例。
一名74岁女性因眩晕和颈部肿块就诊，鼻咽喉镜检查发现鼻咽部有息肉样病变。肿块活检显示上皮样细胞肉芽肿，伴有干酪样坏死和多核巨细胞，符合结核表现。由于临床检查除颈部淋巴结外其他器官无结核病变，我们将该病例诊断为原发性鼻咽结核合并结核性颈淋巴结炎。经异烟肼、利福平及乙胺丁醇化疗4个月后，鼻咽部病变消失。
大多数报道的鼻咽结核病例发生在年轻人群中。本文报告了一例罕见的老年女性合并结核性颈淋巴结炎的病例。
