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一例上皮性腺瘤样错构瘤误诊为鼻息肉的病例报告。

A case report of epithelial adenomatoid hamartoma misdiagnosed as a nasal poly.

作者信息

Liu Siyu, Bai Bin, Feng Yu, Li Maocai, Li Lianqing, Gong Lili

机构信息

Department of Otorhinolaryngology Head and Neck Surgery, Liaocheng People's Hospital, Liaocheng, China.

School of Clinical Medicine, Shandong Second Medical University, Weifang, China.

出版信息

Medicine (Baltimore). 2025 Feb 14;104(7):e41424. doi: 10.1097/MD.0000000000041424.

Abstract

RATIONALE

Respiratory epithelial adenomatoid hamartomas (REAH) are benign tumors. The clinical presentation of REAH often resembles that of nasal polyps or inverted papillomas. Owing to the lack of specific clinical symptoms or imaging findings, the diagnosis is usually confirmed only by pathological examination after surgery and misdiagnosis is common. Therefore, we report this case of nasal REAH that was misdiagnosed as a nasal polyp. Clinical cases of nasal polyps with hamartoma are very rare. Pathological biopsy, complete removal of the lesion by surgery and postoperative follow-up are essential for the diagnosis and treatment of REAH.

PATIENT CONCERNS

The patient had been experiencing bilateral anosmia for 6 years without any obvious triggers. He also experienced nasal congestion and mucopurulent nasal discharge after exposure to cold and alcohol.

DIAGNOSIS

Analyzing the pathological findings that the patient was diagnosed with right-sided respiratory epithelial adenomatoid pleomorphic histiocytoma and left-sided nasal polyps.

INTERVENTIONS

Nasal endoscopic surgery was performed to remove bilateral nasal lesions and send them for routine pathological examination.

OUTCOMES

After surgery, the patient's sense of smell was slightly restored to normal.

LESSONS

Our case report findings suggest that clinical attention should be paid to the possibility of nasal REAH with nasal polyps in bilateral nasal polypoid masses, particularly if the olfactory fissure is involved.

摘要

理论依据

呼吸道上皮性腺瘤样错构瘤(REAH)是良性肿瘤。REAH的临床表现常类似于鼻息肉或内翻性乳头状瘤。由于缺乏特异性临床症状或影像学表现,通常仅在手术后通过病理检查才能确诊,误诊很常见。因此,我们报告这例被误诊为鼻息肉的鼻腔REAH病例。伴有错构瘤的鼻息肉临床病例非常罕见。病理活检、手术彻底切除病变及术后随访对REAH的诊断和治疗至关重要。

患者情况

患者双侧嗅觉丧失6年,无明显诱因。接触寒冷和酒精后还出现鼻塞和脓性鼻涕。

诊断

通过分析病理结果,患者被诊断为右侧呼吸道上皮性腺瘤样多形性组织细胞瘤和左侧鼻息肉。

干预措施

进行鼻内镜手术切除双侧鼻腔病变并送常规病理检查。

结果

术后患者嗅觉稍有恢复正常。

经验教训

我们的病例报告结果表明,对于双侧鼻息肉样肿物,尤其是累及嗅裂时,临床应注意鼻腔REAH合并鼻息肉的可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e945/11835112/0d886c4faca2/medi-104-e41424-g001.jpg

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