Head & Neck Institute, Cleveland Clinic, Cleveland, OH, USA.
Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland, OH, USA.
Int J Pediatr Otorhinolaryngol. 2020 Nov;138:110308. doi: 10.1016/j.ijporl.2020.110308. Epub 2020 Aug 13.
This is a case of a premature infant with stridor, supplemental oxygen requirement, and dysphagia refractory to anti-reflux and anti-inflammatory medications. Endoscopy revealed postcricoid fullness with MRI showing submucosal lobulations. Microscopic resection of an obstructive postcricoid mass resulted in immediate resolution of stridor and oxygen requirement with mild improvement in dysphagia. Pathology demonstrated submucosal fibrosis, edema, and vascularity with no evidence of malignancy, fibromatosis, or cystic/polypoid components. Review of the literature shows that lesions in postcricoid region include amyloidosis, lymphatic malformation, and normal-variant hypertrophy. Surgery should be considered for atypical postcricoid lesions with symptoms refractory to medical management.
这是一例患有喘鸣、需要补充氧气以及对反流和抗炎药物治疗有抗药性的吞咽困难的早产儿。内窥镜检查显示杓状软骨后区饱满，磁共振成像显示黏膜下分叶。阻塞性杓状软骨后区肿块的显微镜下切除导致喘鸣和氧气需求立即得到解决，吞咽困难略有改善。病理学显示黏膜下纤维化、水肿和血管化，无恶性肿瘤、纤维瘤病或囊性/息肉样成分的证据。文献回顾表明，杓状后区的病变包括淀粉样变性、淋巴管畸形和正常变异型肥大。对于有症状且对药物治疗有抗药性的非典型杓状后区病变，应考虑手术治疗。
