儿童腮腺区嗜酸性粒细胞增多性淋巴肉芽肿3例

Three cases of eosinophilichyperplastic lymphogranuloma in children's parotid area

2009年3—10月收治3例腮腺区肿块的患儿,术前检查可见:腮腺区局限性隆起,表面皮肤呈暗淡紫红色,边界不清,不活动;血清IgE明显升高;B超检查病灶为等回声团,周围有低回声暗带包绕,呈"牛眼征";磁共振成像检查提示为皮下与腮腺之间的囊性病变。术前诊断为嗜酸性粒细胞增多性淋巴肉芽肿(木村病),均行手术切除治疗。术后病理检查见局部组织内毛细血管增生,伴多量嗜酸性粒细胞、淋巴细胞浸润,证实为嗜酸性粒细胞增多性淋巴肉芽肿。由此可见,该病虽然罕见,通过术前查体、实验室及影像学检查仍可以作出诊断,为相应的治疗提供依据。

From March 2009 to October 2009,three pediatric patients with parotid tumor were cured.Preoperative physical examination showed regional swelling in parotid area,the surface skin was in moderate reddish purple,the border was vague,and the swelling was inactive.The patients＇IgE were significantly increased.B ultrasound examination demonstrated the focus was an isoecho with ringlike dark band around,which was concluded as bull＇s-eye sign. Magnetic resonance imaging（MRI） examination indicated a cystic mass between the skin and parotid.Preoperative diagnosis was eosinophilichyperplastic lymphogranuloma（Kimura＇s disease） and the granuloma was excised by operation. Pathological examination revealed the capillary vessel hyperplasia in local tissue with a plenty of eosinophils and lymphocytes infiltrating.The disease was confirmed.Although the disease is rare,the diagnosis still could be made by preoperative physical examination,laboratory and imaging examinations.