Départment of Internal Medicine, Hédi Chaker University Hospital, 3029 Sfax, Tunisia.
Eur Arch Otorhinolaryngol. 2012 Apr;269(4):1301-4. doi: 10.1007/s00405-011-1886-2. Epub 2011 Dec 25.
Localized amyloidosis of the tonsil is rare and its management depends on the etiology. We report a case of tonsil amyloidosis and review the characteristics of this exceptional pathology. A 74-year-old man consulted for odynophagia, upper dysphagia and deteriorated general health status, which have been evolving for 1 year. Clinical examination found a smooth swelling of the right palatine tonsil. No further abnormalities were noted. The biopsy findings were consistent with amyloidosis. Etiological assessment pointed to Waldenstrom macroglobulinemia. Tonsillectomy was performed. The patient was managed by chemotherapy associating chlorambucil, vincristine and prednisone. The progress after chemotherapy was good. Localized amyloidosis is a rare lesion of the superior aerodigestive tract, predominating in the larynx and tonsil involvement is exceptional. Its diagnosis is histological and its management depends on the etiology. Continued regular follow-up is necessary to look for recurrence.
扁桃体局部淀粉样变性罕见，其治疗取决于病因。我们报告一例扁桃体淀粉样变性病例，并复习这一罕见病变的特点。一名 74 岁男性因咽痛、吞咽困难和逐渐恶化的全身健康状况就诊，这些症状已持续 1 年。临床检查发现右侧腭扁桃体光滑肿胀。无其他异常。活检结果符合淀粉样变性。病因评估提示瓦尔登斯特伦巨球蛋白血症。行扁桃体切除术。患者接受联合应用苯丁酸氮芥、长春新碱和泼尼松的化疗。化疗后病情进展良好。局限性淀粉样变性是上呼吸道的罕见病变，以喉部为主，扁桃体受累罕见。其诊断依靠组织学，治疗取决于病因。需要持续定期随访以寻找复发。
