舌扁桃体肥大172例的临床病理观察

• 作 者: 董都选 郑海明 石萍霞 李允利
• 机 构: 宝鸡市中医医院病理科,宝鸡市中医医院耳鼻咽喉科,宝鸡市中医医院病理科,宝鸡市中医医院病理科 陕西宝鸡,721001,陕西宝鸡,721001,陕西宝鸡,721001
• 出 处: 临床耳鼻咽喉科杂志
• 发表日期: 2004年09期
• 关键词: 舌扁桃体 肥大 病理学

目的 :提高临床对舌扁桃体肥大的认识及重视。方法 :对 172例患者在直达喉镜下用喉钳钳夹去除肥大的舌扁桃体组织 ,然后用离子或微波治疗机处理残余部分。标本用 4 %甲醛固定 ,常规切片 ,苏木精 伊红染色 ,显微镜观察。结果 :治愈及显效 80 .81% ,有效 15 .12 % ,无效 4 .0 7%。病理学以淋巴组织增生为主 ,滤泡增生型 76例 (4 4 .19% ) ,弥漫增生型 5 5例 (31.98% ) ,混合增生型 33例 (19.19% ) ,肉芽样增生型 5例 (2 .91% ) ,放线菌性脓肿 3例 (1.74 % )。伴上皮淋巴细胞浸润或破坏者 113例 ,2 2例糜烂形成 ,91例滤泡腔扩张炎性渗出或囊肿形成。此外 ,发现 5 7例放线菌等病原菌感染。结论 :舌扁桃体肥大是局部淋巴组织对病原反应性过度增生及上皮损害的结果 ,是顽固性咽部异感症的主要病变 ,应引起临床重视。钳夹去除术加离子或微波治疗是行之有效的治疗方法。

Objective: To improve clinical awareness of tongue tonsil hypertrophy and attention. METHODS: Twenty-two patients underwent laryngoscopy to remove hypertrophic lingual tonsil tissue in a direct laryngoscope, and the remainder was treated with ion or microwave therapy. Specimens were fixed with 4% formaldehyde, routinely sliced, stained with hematoxylin and eosin and observed under a microscope. Results: 80.81% were cured and markedly effective, 15.12% effective and 4. 0 7% effective. Pathological lymphoid hyperplasia, hyperplastic follicular hyperplasia in 76 cases (44.19%), diffuse hyperplasia in 55 cases (31.98%), mixed hyperplastic in 33 cases (19.19%), granulomatous hyperplasia in 5 cases (2.91%), Actinomyces abscess in 3 cases (1.74%). There were 113 cases with epithelial infiltration or destruction of epithelial lymphocytes, 22 cases with erosion, and 91 cases with follicular cavity expansion and inflammatory exudation or cyst formation. In addition, 57 cases of actinomycetes and other pathogen infections were found. Conclusion: Tongue tonsillar hypertrophy is the result of local lymphoid tissue hyperplasia and epithelial damage of pathogen. It is the main lesion of intractable pharyngeal heterosis. It should be clinically valued. Clamp removal plus ion or microwave therapy is an effective treatment.