头颈部嗜酸性淋巴肉芽肿43例临床诊治经验

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摘要目的探讨头颈部嗜酸性淋巴肉芽肿（ELG）的临床特征及诊疗经验，提高临床医生对该病的认识，降低临床误诊、漏诊及复发率。方法收集2000年7月~2017年1月就诊于武汉大学人民医院且经病理检查确诊的43例头颈部ELG患者的临床资料。对患者的基本信息、临床症状、常规血液检查、影像学检查、病理检查、治疗方案及随访情况等进行总结。结果患者多以反复发作的无痛性肿胀为首发症状来诊，肿块可单一或多个并存，可伴有皮肤瘙痒或色素沉着。病变部位以颈部（24例）为主，其次为腮腺（9例）。实验室检查中33例嗜酸性粒细胞明显升高，31例IgE明显升高。所有患者视病情接受手术、糖皮质激素或放疗等治疗。26例患者为单纯手术，复发9例；13例接受两种（手术+放疗或激素+放疗）联合治疗，仅1例复发。结论 ELG的主要临床表现为无痛性肿块、外周血嗜酸性粒细胞和血清IgE升高，其确诊依赖病理检查。手术治疗是首选治疗方法，联合放疗及激素治疗可降低复发率。

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	江洋1 华清泉1 任杰1 曾峰1 盛建飞1 张志坚1 管红霞2 袁静萍3

关键词 ：嗜酸性淋巴肉芽肿, 木村病, 嗜酸性粒细胞

Abstract：Objective To explore the clinical features and diagnosis and treatment of eosinophilic lymphatic granuloma (ELG) of head and neck, in order to improve awareness of the disease in clinicians, reduce the clinical misdiagnosis, missed diagnosis rate and the recurrence rate. Methods The clinical data of 43 patients with ELG of head and neck surgery were confirmed by pathological examination in Renmin Hospital of Wuhan University from July 2000 to January 2017 were collected. The detailed data were summarized, including basic information, clinical symptoms, routine blood tests, imaging examination, pathological examination and recurrence. Results The patients were often treated with recurrent painless swelling as the initial symptom, which could be single or multiple, and could be accompanied by skin itching or pigmentation. The diseased region was mainly in the neck (24 cases), followed by the parotid gland (9 cases). In laboratory examination, eosinophilic granulocytes in 33 cases were significantly elevated, and IgE in 31 cases were increased significantly. 26 cases were treated by simple surgery, with 9 cases recurrence; 13 cases were treated with combined treatment (surgical + radiotherapy or hormone + radiotherapy), with only one case recurrence. Conclusion The main clinical manifestations of ELG are painless mass, increased peripheral blood eosinophils and serum IgE, and its diagnosis relies on pathological examination. Surgical treatment is the preferred treatment, and combined radiotherapy and hormone therapy can reduce recurrence rate.

Key words： Eosinophilic lymphogranulomal Kimura disease Eosinophil

基金资助:湖北省自然科学基金项目（2016CFB661）。

作者简介: 江洋（1977.12-），男，博士；研究方向：头颈外科。

引用本文:

江洋1 华清泉1 任杰1 曾峰1 盛建飞1 张志坚1 管红霞2 袁静萍3. 头颈部嗜酸性淋巴肉芽肿43例临床诊治经验[J]. 中国医药导报, 2017, 14(31): 44-47.
JIANG Yang1 HUA Qingquan1 REN Jie1 ZENG Feng1 SHENG Jianfei1 ZHANG Zhijian1 GUAN Hongxia2 YUAN Jingping3. Clinical diagnosis and treatment of 43 cases of eosinophilic lymphatic granuloma of head and neck. 中国医药导报, 2017, 14(31): 44-47.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I31/44

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