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喉结核:被忽视的诊断。

Laryngeal tuberculosis: a neglected diagnosis.

机构信息

ENT, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Pathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

BMJ Case Rep. 2022 Feb 7;15(2):e248095. doi: 10.1136/bcr-2021-248095.

Abstract

A 24-year-old woman visited the Ear Nose Throat (ENT) outpatient department with complaints of hoarseness for 2 months not responding to conservative management. Laryngoscopic examination revealed a whitish ulceroproliferative lesion in the anterior commissure and anterior two-thirds of bilateral true vocal cords with surrounding necrosis. In view of the above findings, the patient was planned for biopsy under general anaesthesia. Intraoperative findings showed multiple whitish necrotic friable tissue involving anterior two-thirds of bilateral false vocal cords, ventricle, bilateral true vocal cords, both aryepiglottic folds and laryngeal surface of epiglottis. Postoperative histopathology was consistent with tuberculosis. A pulmonology consultation was taken, and the patient was started on anti-tuberculosis chemotherapy. One month post therapy, the voice was symptomatically better. A flexible fibreoptic laryngoscopic examination was done, which revealed almost complete resolution of the lesion with minimal ulceration at the anterior one-third of right true vocal cord.

摘要

一位 24 岁女性因 2 个月的声音嘶哑就诊于耳鼻喉科门诊,经保守治疗后无缓解。喉镜检查显示在前联合和双侧真声带的前 2/3 处有白色增生性溃疡病变,伴有周围坏死。鉴于上述发现,计划在全身麻醉下进行活检。术中发现双侧假声带的前 2/3 处、室带、双侧真声带、杓会厌皱襞和会厌喉面均有多处白色坏死易碎组织。术后组织病理学检查符合结核。请肺病专家会诊,患者开始接受抗结核化疗。治疗一个月后,声音症状明显改善。进行了软性纤维喉镜检查,显示病变几乎完全消退,右侧真声带前 1/3 处仅有轻微溃疡。

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本文引用的文献

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Laryngeal tuberculosis: A report of 17 cases.喉结核:17例报告。
Auris Nasus Larynx. 2015 Aug;42(4):305-10. doi: 10.1016/j.anl.2015.02.012. Epub 2015 Mar 3.
4
Clinical photograph. Laryngopharyngeal tuberculosis masquerading as chronic laryngopharyngitis.临床照片。伪装成慢性喉咽炎的喉咽结核。
Otolaryngol Head Neck Surg. 2009 Oct;141(4):537-8. doi: 10.1016/j.otohns.2009.05.013. Epub 2009 Aug 28.
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Laryngeal tuberculosis: a report of 15 cases.喉结核:15例报告
Ann Otol Rhinol Laryngol. 2002 Oct;111(10):916-8. doi: 10.1177/000348940211101010.
7
Laryngeal tuberculosis: CT findings.喉结核:CT表现
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