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孤立性喉结核:诊断难题

Isolated Laryngeal Tuberculosis: a Diagnostic Dilemma.

作者信息

Pandiyan Harsha, Sivanand Nikhil, Sathish Kumar S

机构信息

Department of ENT, Vydehi Institute of Medical Sciences and Research Centre, Whitefield, Bengaluru, Karnataka India.

Department of ENT, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pillaiyarkuppam, Pondicherry, India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2022 Oct;74(Suppl 2):2308-2310. doi: 10.1007/s12070-020-02139-7. Epub 2020 Sep 10.

Abstract

Laryngeal tuberculosis is a rare condition, isolated laryngeal tuberculosis without pulmonary manifestations is even more rare. Patients usually presents with voice change, difficulty in swallowing and other constitutional symptoms. The symptoms and findings can look like malignancy in most of the cases. Here, we present a case of primary laryngeal tuberculosis without pulmonary tuberculosis. A 24 year old man who presented to us with hoarseness of voice with 1 year duration. Laryngoscopic study showed a proliferative growth in the epiglottis, aryepiglottic folds and vocal cords and was diagnosed to have laryngeal tuberculosis on histopathology by the typical appearance of granuloma and caseous necrosis. The patient was started on standard antitubercular therapy and he had an excellent response to the same within 6 months. Isolated laryngeal tuberculosis should be suspected in patients with laryngeal complaints with no pulmonary symptoms, especially in a developing country like India where pulmonary tuberculosis is prevalent. Even though isolated laryngeal tuberculosis cases are rare, we should keep in mind the possibility of tuberculosis in the differential diagnosis of laryngeal tumors, as the incidence of tuberculosis is steadily increasing.

摘要

喉结核是一种罕见疾病,孤立性喉结核且无肺部表现的情况更为罕见。患者通常表现为声音改变、吞咽困难及其他全身症状。在大多数病例中,这些症状和表现可能类似恶性肿瘤。在此,我们报告一例无肺结核的原发性喉结核病例。一名24岁男性因声音嘶哑1年前来就诊。喉镜检查显示会厌、杓会厌襞及声带出现增生性肿物,经组织病理学检查,根据肉芽肿和干酪样坏死的典型表现诊断为喉结核。该患者开始接受标准抗结核治疗,6个月内病情有显著好转。对于有喉部症状但无肺部症状的患者,尤其是在像印度这样肺结核流行的发展中国家,应怀疑孤立性喉结核。尽管孤立性喉结核病例罕见,但在喉肿瘤的鉴别诊断中我们应牢记结核病的可能性,因为结核病的发病率在稳步上升。

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引用本文的文献

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Isolated laryngeal tuberculosis: A diagnostic dilemma.
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