Niu Yanyan, Li Yongjin, Wang Jian, Jin Xiaofeng, Yang Dahai, Huo Hong, Li Wuyi
Department of ENT, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Biomed Res Int. 2017;2017:8521818. doi: 10.1155/2017/8521818. Epub 2017 Jul 9.
This study was performed to investigate the clinical manifestations, treatment methods, and prognosis of Rosai-Dorfman disease (RDD) with laryngeal involvement. Five clinical cases of RDD with laryngeal involvement diagnosed between 1986 and 2015 were retrospectively analyzed. The laryngeal lesions of these 5 patients mostly involved the glottis and subglottis, with the main symptoms being a hoarse voice and airway obstruction. In addition, the patients mostly exhibited a unilateral or asymmetric onset that was manifested by a laryngeal submucosal nodular mass. The patients were subjected to a regimen of hormone treatment combined with surgical resection. The median follow-up duration was 101 months (8-384 months). One case was lost, and the remaining 4 subjects are alive with disease. The follow-up examinations revealed that 4 subjects had stable laryngeal conditions, whereas one showed minor progression. RDD with laryngeal involvement is clinically rare and differs considerably from classical RDD in age of onset, gender composition, and extranodal involvement. The regimen of hormone treatment combined with surgical resection can stabilize the patient's general condition and laryngeal lesion. Tracheotomies are recommended for patients with dyspnea. After their conditions stabilize, decannulation can be successfully performed in most cases. This therapeutic regimen generally delivers a good prognosis.
本研究旨在探讨累及喉部的Rosai-Dorfman病(RDD)的临床表现、治疗方法及预后。对1986年至2015年间诊断的5例累及喉部的RDD临床病例进行回顾性分析。这5例患者的喉部病变大多累及声门和声门下区,主要症状为声音嘶哑和气道梗阻。此外,患者大多表现为单侧或不对称发病,表现为喉部黏膜下结节状肿物。患者接受了激素治疗联合手术切除的方案。中位随访时间为101个月(8 - 384个月)。1例失访,其余4例带瘤生存。随访检查显示,4例患者喉部情况稳定,1例有轻微进展。累及喉部的RDD临床罕见,在发病年龄、性别构成及结外受累情况方面与经典RDD有很大差异。激素治疗联合手术切除的方案可稳定患者的一般状况及喉部病变。对有呼吸困难的患者建议行气管切开术。病情稳定后,大多数病例可成功拔管。这种治疗方案总体预后良好。