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酷似扁桃体癌的扁桃体结核:一例报告

Tonsillar tuberculosis mimicking tonsillar carcinoma: A case report.

作者信息

Ben Ammar Chaima, Tbini Makram, Kamel Houssem Eddine, Riahi Ines, Ben Salah Mamia

机构信息

ENT Department, Charles Nicolle Hospital, Boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia.

ENT Department, Charles Nicolle Hospital, Boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Faculty of Medicine of Tunis, University Tunis el Manar, Tunisia.

出版信息

Int J Surg Case Rep. 2024 Aug;121:110032. doi: 10.1016/j.ijscr.2024.110032. Epub 2024 Jul 12.

Abstract

INTRODUCTION

Extrapulmonary tuberculosis is rare even in endemic areas, and is dominated by lymph node involvement. Tonsillar tuberculosis is exceptional. The clinical examination and radiological explorations are non-specific.

CASE PRESENTATION

A 45-year-old woman presented with chronic odynophagia and otalgia. Examination revealed an enlarged left palatine tonsil with an irregular surface and a firm consistency. Radiologic exploration was not specific. The patient underwent a tonsillar biopsy. Histopathology was consistent with tuberculosis and the patient was put on antitubercular drugs.

CLINICAL DISCUSSION

Tuberculosis is a global public health problem. Extrapulmonary tuberculosis is rare and mainly affects lymph nodes. Tonsillar tuberculosis is frequentely seen in individuals with immunodeficiency. Clinical features and imaging findings are non-specific. Diagnosis is based on histopathological and microbiological findings to rule out differential diagnoses especially cancer. Treatment is based on anti-tuberculosis drugs.

CONCLUSION

Our case illustrates a rare presentation of primary tuberculosis and highlights the importance of considering tuberculosis as a potential cause of tonsillitis.

摘要

引言

肺外结核即使在流行地区也很罕见,且以淋巴结受累为主。扁桃体结核则更为罕见。临床检查和影像学检查均无特异性。

病例介绍

一名45岁女性,出现慢性吞咽痛和耳痛。检查发现左侧腭扁桃体肿大,表面不规则,质地硬。影像学检查无特异性。患者接受了扁桃体活检。组织病理学检查结果符合结核病,患者开始接受抗结核药物治疗。

临床讨论

结核病是一个全球性的公共卫生问题。肺外结核罕见,主要累及淋巴结。扁桃体结核常见于免疫缺陷个体。临床特征和影像学表现无特异性。诊断基于组织病理学和微生物学检查结果,以排除特别是癌症等鉴别诊断。治疗以抗结核药物为主。

结论

我们的病例说明了原发性结核的一种罕见表现,并强调了将结核病视为扁桃体炎潜在病因的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b801/11284545/eaa20dd7f303/gr1.jpg

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