头颈部嗜酸性淋巴肉芽肿诊断与治疗

Diagnosis and management of eosinophilic lymphoid granuloma in the head and neck

目的探讨头颈部嗜酸性淋巴肉芽肿(ELG)的病理、诊断及治疗。方法回顾性分析10例ELG患者的临床、病理资料。结果 10例主要临床表现为颌下、面颊部、耳周腮腺区、耳后乳突区无痛性多发肿块,多发颈部淋巴结肿大,肿块处的皮肤瘙痒及色素沉着;外周血象中嗜酸性粒细胞比例和计数明显升高。其中合并有肾病综合征1例。10例患者均行手术治疗,术后病理诊断为嗜酸性淋巴肉芽肿。术后复发5例,予以放射治疗随诊3年未复发1例,予以再次手术治疗控制4例。结论头颈部嗜酸性淋巴肉芽肿具有典型的临床和病理学特点,治疗包括外科手术切除、小剂量放射治疗以及类固醇类药物。

Objective To systematically analyze the pathological and clinical features of eosinophilic lymphoid granuloma （ELG） to improve the diagnosis and treatment. Method The clinical data of 10 cases of ELG were reviewed. Results Of all the 10 cases, there were 6 males and 4 females, with ages between 29 and 59. Among the 10 cases, the typical clinical presentation was painless soft tissue masses predominantly in the parotid and submaxillary region and combined with peripheral eosinophilia. The pathological findings were the marked infiltration of eosinophil,lymphocytic proliferation,lymphatic follicles, variable degrees of fibrosis and vascular proliferation. Conclusion ELG is a chronic inflammatory disease which features distinctive clinical as well as histological characteristics. Treatments in- clude surgery, medication and radiotherapy.