头颈部淀粉样变性23例临床分析

Amyloidosis of the head and neck: a clinicopathological study of 23 cases

目的探讨头颈部淀粉样变性的临床表现、诊断、治疗和预后。方法对南京医科大学第一附属医院2007年4月至2018年10月收治的23例头颈部淀粉样变患者的临床资料进行回顾性分析并总结。结果23例患者均行手术治疗,其中16例为原发性局部性淀粉样变,7例为继发性局部性淀粉样变。术后随访5个月至11年,其中2例多发性局部淀粉样变患者术后复发,表现为声嘶及咽部异物感,5例失访,余患者未见明显复发。结论头颈部淀粉样变性临床表现多变,内镜下形态无特异性,确诊依赖于病理切片刚果红染色;该病症发展缓慢,有复发倾向;治疗应根据病变范围选择合理术式并彻底切除病灶,术后需长期随访观察。

Objective The objective of this study was to investigate the clinical features,diagnosis,treatment,and prognosisofamyloidosis of the head and neck region.Methods The clinical data of 23 patients who were pathologically diagnosed with amyloidosis and admitted to our hospital from the April of 2007 to October 2018 were collected and analyzed.Results The study included 16 patients with primary localized amyloidosis and 7 patients with secondary localized amyloidosis.All the patients received surgical treatment.Postoperative follow-up ranged from 5 months to 11 years.Recurrence was observed in 2 patients who presented with multiple-localized amyloidosis,hoarseness,and foreign body sensation.Conclusion Clinical manifestations of amyloidosis of the head and neck region are variable.This disease develops slowly and tends to recur.The laryngoscopic characteristics are diverse and necessitate distinction from other tumors.However,it can be diagnosed by staining with Congo red in pathological sections.Treatment of amyloidosis is mostly surgical and based on long-term follow-up.