Oguz Aynur, Karadeniz Ceyda, Citak Elvan Caglar, Conly Nalan Akyurek, Ileri Fikret, Boyunaga Oznur, Okur Visal, Uluoglu Omer
Gazi University, Department of Pediatric Oncology, Ankara, Turkey.
Pediatr Hematol Oncol. 2005 Jul-Aug;22(5):423-35. doi: 10.1080/08880010590964417.
Anterior mediastinal and adenoid masses in children after cessation of chemotherapy for malignant disease often cause a diagnostic problem. Differential diagnosis of thymic enlargement and adenoid hyperplasia from recurrence frequently poses a challenge both for the radiologist and the physician. In this study the authors evaluated 491 patients with different malignant tumors for thymic and adenoid hyperplasia. Thymic hyperplasia was seen in 18 patients (5 Hodgkin disease (HD), 5 non-Hodgkin lymphoma (NHL), 4 Wilms tumor, 2 germ cell tumor, 1 Ewing sarcoma, and 1 neuroblastoma), only adenotonsillar hyperplasia was seen in 6 patients, all with NHL, and both thymic and adenotonsillar hyperplasia were seen in 3 patients (1 HD, 2 NHL). In 5 patients, adenoid hyperplasia was proven by biopsy; 1 patient underwent to adenoidectomy. Their histopathologic investigation showed polyclonal follicular hyperplasia. The authors recommend that patients with thymic and/or adenotonsillar enlargement after successful treatment of their primary malignancy should be evaluated cautiously before an invasive procedure is planned.
恶性疾病化疗结束后儿童出现的前纵隔肿块和腺样体肿块常常会引发诊断难题。区分胸腺增大和腺样体增生与肿瘤复发对放射科医生和内科医生而言都是一项挑战。在本研究中，作者评估了491例患有不同恶性肿瘤的患者的胸腺和腺样体增生情况。18例患者出现胸腺增生（5例霍奇金病（HD）、5例非霍奇金淋巴瘤（NHL）、4例肾母细胞瘤、2例生殖细胞瘤、1例尤因肉瘤和1例神经母细胞瘤），6例患者仅出现腺样体扁桃体增生，均为NHL，3例患者同时出现胸腺和腺样体扁桃体增生（1例HD、2例NHL）。5例患者经活检证实为腺样体增生；1例患者接受了腺样体切除术。他们的组织病理学检查显示为多克隆滤泡增生。作者建议，对于原发性恶性肿瘤成功治疗后出现胸腺和/或腺样体扁桃体增大的患者，在计划进行侵入性检查之前应谨慎评估。
