Dewan Karuna, Shires Courtney B
1Department of Otolaryngology Head and Neck Surgery, Stanford University, 801 Welch Road, Stanford, CA 94305 USA.
2Department of Otolaryngology Head and Neck Surgery, The University of Tennessee Health Sciences Center, Memphis, TN USA.
Indian J Otolaryngol Head Neck Surg. 2019 Oct;71(Suppl 1):790-794. doi: 10.1007/s12070-018-1552-8. Epub 2018 Dec 8.
The danger of the parapharyngeal space mass comes from the small space and vital neighboring structures. Its differential diagnosis is broad, however benign lymphoid hyperplasia in this region has not been previously reported. The clinical presentation, imaging, surgical findings and pathology slides were reviewed in an adult patient with a parapharyngeal space mass. The literature on somatostatin-positive parapharyngeal space lesions was reviewed. A 51-year old male with otalgia for 3 months, hearing loss, and tinnitus underwent audiogram, revealing asymmetric hearing loss. Laryngoscopy demonstrated a paretic true vocal cord. Subsequent MRI demonstrated 4.5 cm post-styloid parapharyngeal space mass displacing the carotid artery anterolaterally. Octreoscan scan showed significant uptake of the somatostatin analog. Angiogram showed prominent vascular blush. The mass was excised transcervically and histopathology demonstrated lymphoid hyperplasia. This case demonstrates that post-styloid parapharyngeal masses may be lateral retropharyngeal nodes. An octreotide-positive lymphoid hyperplasia has never been previously reported.
咽旁间隙肿物的危险源于其狭小的空间及相邻的重要结构。其鉴别诊断范围广泛，然而此前该区域的良性淋巴组织增生未见报道。本文回顾了1例咽旁间隙肿物成年患者的临床表现、影像学检查、手术所见及病理切片。同时回顾了关于生长抑素阳性的咽旁间隙病变的文献。1例51岁男性，有3个月耳痛、听力减退及耳鸣症状，听力图显示不对称性听力减退。喉镜检查发现一侧声带麻痹。随后的磁共振成像（MRI）显示茎突后咽旁间隙有一4.5厘米肿物，将颈动脉向前外侧推移。奥曲肽扫描显示生长抑素类似物摄取明显。血管造影显示有明显的血管染色。经颈部切除肿物，组织病理学显示为淋巴组织增生。该病例表明茎突后咽旁肿物可能是咽后外侧淋巴结。此前从未报道过奥曲肽阳性的淋巴组织增生。
