Weisman R A, Osguthorpe J D
Department of Otolaryngology and Human Communication, University of Pennsylvania School of Medicine, Philadelphia.
Laryngoscope. 1988 Jun;98(6 Pt 1):610-4. doi: 10.1288/00005537-198806000-00006.
Four unusual cases of pseudotumor, which had clinical and radiographic findings suggesting neoplasia, are presented. One involved the maxillary sinus, destroying the lateral wall, and extending to the infratemporal fossa and the orbit. The second presented as an enlarging lacrimal gland tumor with ipsilateral parotid adenopathy, and the third as a large parapharyngeal mass that was diagnosed as a lymphoma on aspiration cytology. The fourth case documented the rare occurrence of a congenital pseudotumor, manifesting as proptosis in a neonate and thought to be a fibrosarcoma on frozen section study. Aggressive pseudotumors must be distinguished from malignancy to avoid unnecessary surgery or irradiation. Some cases can be distinguished from neoplasms by their dramatic response to oral steroid therapy, and others by characteristic features on CT or MRI. Due to the diverse cellular proliferation, aspiration cytology is infrequently helpful and diagnosis can be difficult on frozen section study. An approach to the diagnosis and management of pseudotumors is detailed.
本文介绍了4例不寻常的假瘤病例，其临床和影像学表现提示为肿瘤。1例累及上颌窦，破坏外侧壁，并延伸至颞下窝和眼眶。第2例表现为泪腺肿瘤增大并伴有同侧腮腺淋巴结肿大，第3例表现为巨大的咽旁肿块，细针穿刺细胞学检查诊断为淋巴瘤。第4例记录了先天性假瘤的罕见病例，表现为新生儿眼球突出，冰冻切片检查认为是纤维肉瘤。侵袭性假瘤必须与恶性肿瘤相鉴别，以避免不必要的手术或放疗。一些病例可通过对口服类固醇治疗的显著反应与肿瘤相鉴别，另一些病例可通过CT或MRI的特征性表现来鉴别。由于细胞增殖多样，细针穿刺细胞学检查很少有帮助，冰冻切片检查诊断可能困难。本文详细介绍了假瘤的诊断和处理方法。
