Wenig B M
Armed Forces Institute of Pathology, Department of Otolaryngic and Endocrine Pathology, Washington, DC 20306-6000, USA.
Am J Clin Pathol. 1995 May;103(5):609-13. doi: 10.1093/ajcp/103.5.609.
Two cases of necrotizing sialometaplasia of the larynx are reported. One of the cases occurred in the subglottic larynx of a 37-year-old woman and the other occurred in the right false vocal cord of a 59-year-old man. In both of the cases, the sialometaplasia was identified in association with another pathologic process. The female patient presented with dysphagia. Excisional biopsy was performed twice in the span of an 8-day period. Both biopsy specimens showed fibrosis. The subglottic stenosis was felt to be of undetermined origin. There was evidence of necrotizing sialometaplasia in only the second biopsy material. Subsequently, the patient was diagnosed as having relapsing polychondritis, the probable cause of the subglottic stenosis. The male patient presented with increasing hoarseness and was found to have a mass of the right false vocal cord. Biopsy of the mass was diagnostic for a poorly differentiated squamous cell carcinoma with separate foci of necrotizing sialometaplasia. In both cases, it appears that the sialometaplasia occurred secondary to the other pathologic processes with the likely pathogenesis the result of vascular compromise to the affected area.
报告了两例喉坏死性涎腺化生病例。其中一例发生在一名37岁女性的声门下区，另一例发生在一名59岁男性的右侧假声带。在这两例中，涎腺化生均与另一种病理过程相关。女性患者表现为吞咽困难。在8天内进行了两次切除活检。两份活检标本均显示纤维化。声门下狭窄的病因不明。仅在第二次活检材料中发现坏死性涎腺化生的证据。随后，该患者被诊断为复发性多软骨炎，这可能是声门下狭窄的原因。男性患者表现为声音嘶哑加重，发现右侧假声带肿物。肿物活检诊断为低分化鳞状细胞癌，伴有散在的坏死性涎腺化生灶。在这两例中，涎腺化生似乎是继发于其他病理过程，其可能的发病机制是受累区域血管受损的结果。
