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气道梗阻的罕见病因:声门下嗜酸性细胞囊肿。

Unusual cause of airway obstruction: subglottic oncocytic cyst.

作者信息

Protts Faith Louise Mary Sibthorp, Goh Samantha

机构信息

Otolaryngology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

出版信息

BMJ Case Rep. 2019 Jun 25;12(6):e228663. doi: 10.1136/bcr-2018-228663.

Abstract

Oncocytic cysts are rare benign cystic lesions, which are usually seen in the supraglottic region. They usually present with symptoms of hoarse voice or the sensation of a lump in the throat. Management is with complete excision and follow-up to monitor for recurrence. In this unusual case, an elderly woman presenting with shortness of breath following recent treatment for pneumonia developed rapidly worsening stridor during admission. Flexible nasal endoscopy revealed a large pedunculated cystic lesion arising from the subglottic laryngeal mucosa. A tracheostomy was performed as an emergency and the lesion was then excised. Histology confirmed the diagnosis of a benign oncocytic cyst. Although oncocytic cysts are a recognised benign pathology of the supraglottic larynx, they should remain in the differential diagnosis for the subglottic larynx. Management is based on cases of supraglottic pathology, and we advise careful monitoring for this previously unreported pathology.

摘要

嗜酸细胞囊肿是罕见的良性囊性病变,通常见于声门上区。它们通常表现为声音嘶哑或咽喉部有肿块感等症状。治疗方法是完整切除并进行随访以监测复发情况。在这个不寻常的病例中,一名老年女性在近期肺炎治疗后出现呼吸急促,入院期间喘鸣迅速加重。可弯曲鼻内镜检查发现声门下喉黏膜有一个带蒂的大囊性病变。紧急行气管切开术,随后切除病变。组织学检查确诊为良性嗜酸细胞囊肿。尽管嗜酸细胞囊肿是声门上喉公认的良性病理改变,但对于声门下喉仍应列入鉴别诊断。治疗基于声门上病变的病例,我们建议对这种此前未报道的病理情况进行仔细监测。

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