腭扁桃体错构瘤性息肉：病例报告及文献复习
Hamartomatous Polyp of the Palatine Tonsil: A Case Report and Critical Literature Review.
机构信息
Faculty of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, 79070-900, Brazil.
出版信息
Head Neck Pathol. 2023 Jun;17(2):502-508. doi: 10.1007/s12105-023-01529-x. Epub 2023 Feb 1.
BACKGROUND
Hamartomatous polyp of the palatine tonsil is a rare benign tumor poorly recognized by clinicians and pathologists. We present a novel case report and provide a literature review about this diagnosis, highlighting its clinicopathological features and treatment modalities.
METHODS
We herein report a case of a 22-year-old female patient who complained of a foreign body sensation in her throat. She presented with a pedunculated polyp attached to her right palatine tonsil, which was noticed 15 years ago. An excisional biopsy was performed under local anesthesia, and the microscopic aspect confirmed the diagnosis of the hamartomatous polyp of the palatine tonsil. The literature review was performed using the "palatine tonsil polyps" term in PubMed and Google Scholar. Only English-language publications showing clinical and microscopic descriptions were selected as inclusion criteria.
RESULTS
As in our case report, this poorly understood lesion usually presents as a solitary, unilateral pedunculated mass attached to the palatine tonsil surface with nonspecific symptoms. The literature shows less than 100 cases reported, which reveals a lesion preference for male and young adult patients. Microscopically, it is characterized by disorganized proliferation of the connective tissue components indigenous to the involved site, with variable lymphangiectasia, which accounts for the diversity of the diagnostic term and its unknown incidence. Its treatment consists of excision of the polyp with or without tonsillectomy, and no recurrence or malignant transformation of these polyps has been reported.
CONCLUSION
The hamartomatous polyp of the palatine tonsil is challenging due to its rarity and lack of standardization of the terminology used in the literature. Including this diagnosis in the 5th edition of the World Health Organization Classification for Head and Neck Tumors is expected to contribute to a better understanding of this pathology.
背景
腭扁桃体错构瘤是一种罕见的良性肿瘤，临床医生和病理学家对其认识不足。我们报告了 1 例新病例，并对该诊断进行了文献复习，重点介绍了其临床病理特征和治疗方式。
方法
我们在此报告 1 例 22 岁女性患者，其咽部有异物感。患者 15 年前发现右侧腭扁桃体有一带蒂息肉，大小约 1cm。在局部麻醉下行息肉切除术，显微镜下观察符合腭扁桃体错构瘤的诊断。通过“腭扁桃体息肉”这一关键词在 PubMed 和 Google Scholar 上进行文献复习，仅选择有临床和显微镜描述的英文文献作为纳入标准。
结果
正如我们的病例报告一样，这种认识不足的病变通常表现为孤立的、单侧带蒂的肿块，附着于腭扁桃体表面，症状不特异。文献报道不足 100 例，提示该病变好发于男性和年轻成年患者。显微镜下，其特征为固有部位的结缔组织成分呈无序增生，伴有不同程度的淋巴管扩张，这也是导致该病变诊断术语多样化和发病率未知的原因。其治疗方法为息肉切除术，伴或不伴扁桃体切除术，这些息肉无复发或恶变报道。
结论
由于腭扁桃体错构瘤罕见，且文献中使用的术语缺乏标准化，因此诊断具有挑战性。将其纳入第 5 版《头颈部肿瘤世界卫生组织分类》有望促进对这种病理学的更好理解。
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