Campanelli P, Orlando A, Leombruni E, Campanelli S, Ghimenti A, Ossanna P, Picardi N
Cattedra di Chirurgia Generale, Facoltà di Medicina e Chirurgia, Università degli studi G. D'Annunzio di Chieti.
Ann Ital Chir. 1993 Jul-Aug;64(4):429-36; discussion 437.
The case of a retrosternal localization of Hodgkin disease is a very infrequent one, and its presentation as an inflammatory tumor is exceptional indeed. This case report of a young woman affected by a cervical tumour projecting in front of the sternal bone, both with fever and tenderness, gave a mistaken address toward a diagnosis of suppurative thyroiditis. But the rare evenience of this thyroidal affection made the diagnosis very improbable and the patient was treated by partial exeresis of the cervical mass and drainage of its apparently suppurative content. At the pathologic study the mass revealed its true nature, also if very unusual: the appearance of the specimen, studied also with immuno-chemical methods, revealed its true nature of scleronodular Hodgkin disease probably born on a thymic cyst remnant. Also the possibility of a suppurative evolution from a pyriform laryngeal sinus is discussed, but simply on a differential diagnostic basis for the original hypothesis of an inflammatory mass. The correct diagnosis instead offered the patient the possibility of the correct chemo-radio-therapeutic treatment and of final cure.
霍奇金病位于胸骨后实属罕见,而表现为炎性肿瘤的情况更是极为特殊。本病例报告的是一位年轻女性,其颈部肿瘤突出于胸骨前方,伴有发热和压痛,最初被误诊为化脓性甲状腺炎。但这种甲状腺疾病极为罕见,使得该诊断极不可能,于是患者接受了颈部肿块部分切除术及对其明显化脓性内容物的引流。病理研究显示肿块的真实性质,尽管非常罕见:标本外观,包括采用免疫化学方法进行的研究,揭示其为硬化结节型霍奇金病,可能起源于胸腺囊肿残余。文中还讨论了来自梨状喉窦化脓性演变的可能性,但仅作为对炎性肿块最初假设的鉴别诊断依据。正确的诊断为患者提供了接受正确放化疗治疗并最终治愈的可能性。