Srirompotong Somchai, Yimtae Kwanchanok, Jintakanon Darunee
Department of Otolaryngology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand.
Otolaryngol Head Neck Surg. 2004 Nov;131(5):762-4. doi: 10.1016/j.otohns.2004.02.052.
OBJECTIVES/HYPOTHESIS: To present the clinical manifestation of nasopharyngeal tuberculosis.
Clinical analysis of 23 patients with pathologically confirmed nasopharyngeal tuberculosis was carried out retrospectively.
Srinagarind Hospital, Khon Kaen University. Thailand.
The most common presenting symptom was cervical lymphadenopathy (91.3%). The common locations of nodes were the superior and middle cervical. The abnormalities of the nasopharynx were found in 16 patients. The pathological findings were caseous granuloma with positive acid-fast bacilli (AFB) in 15 cases, caseous granuloma with negative AFB in 3 cases, and chronic granulomatous inflammation with negative AFB in 5 cases. Pulmonary tuberculosis was found in 8 of 18 patients. Sixteen patients who received complete treatment responded well.
Nasopharyngeal tuberculosis commonly presents with cervical lymphadenopathy. The differential diagnosis of tuberculosis from nasopharyngeal carcinoma is difficult. In the patients who have cervical lymphadenopathy and no other identified causes, biopsy of nasopharynx would give an additive information for diagnosis.
目的/假设:阐述鼻咽结核的临床表现。
对23例经病理确诊的鼻咽结核患者进行回顾性临床分析。
泰国孔敬大学诗里拉吉医院。
最常见的症状是颈部淋巴结肿大(91.3%)。淋巴结常见部位为颈上部和中部。16例患者发现鼻咽部异常。病理结果显示,15例为干酪样肉芽肿且抗酸杆菌(AFB)阳性,3例为干酪样肉芽肿且AFB阴性,5例为慢性肉芽肿性炎症且AFB阴性。18例患者中有8例发现肺结核。16例接受完整治疗的患者反应良好。
鼻咽结核常表现为颈部淋巴结肿大。结核与鼻咽癌的鉴别诊断困难。对于有颈部淋巴结肿大且无其他明确病因的患者,鼻咽活检可为诊断提供补充信息。