异位胸腺疝引起的间歇性胸骨上颈部肿块：两例报告
Intermittent Suprasternal Neck Mass Caused by Herniation of Ectopic Thymus: Report of Two Cases.
作者信息
Tey Kai-Jun, Goh Bee-See, Mohd-Zaki Faizah
机构信息
Department of Otorhinolaryngology, Head and Neck Surgery, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
出版信息
Iran J Otorhinolaryngol. 2020 Nov;32(113):391-395. doi: 10.22038/ijorl.2020.45727.2501.
INTRODUCTION
Ectopic thymus is an uncommon cause of neck masses in children that frequently present as lateral cervical swelling especially on the right side.
CASE REPORT
We report two cases with atypical clinical presentation of ectopic thymus and superior herniation of normal thymus. Both of the patients manifested as intermittent midline mass at the suprasternal region during Valsalva manuevre. Unique ultrasound features with the location along the thymic descent together with dynamic assessment of the organ movement were essential to reach the correct diagnosis. Conservative approach was considered in these patients considering the necessity of thymus in the process of puberty.
CONCLUSION
High index of suspicion is of utmost importance when encounter patient with similar clinical manifestation to avoid unnecessary diagnostic modalities and surgeries. Accurate diagnosis will also alleviate parents' anxiety.
引言
异位胸腺是儿童颈部肿块的罕见病因，常表现为颈部外侧肿胀，尤其是右侧。
病例报告
我们报告两例具有非典型临床表现的异位胸腺及正常胸腺向上疝出的病例。两名患者在瓦尔萨尔瓦动作时均表现为胸骨上区域间歇性中线肿块。沿胸腺下降路径的独特超声特征以及对器官运动的动态评估对于做出正确诊断至关重要。考虑到青春期胸腺的必要性，对这些患者采取了保守治疗方法。
结论
遇到有类似临床表现的患者时，高度怀疑至关重要，以避免不必要的诊断方式和手术。准确的诊断也将减轻家长的焦虑。
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