鼻腔呼吸道上皮腺瘤样错构瘤

Respiratory epithelial adenomatoid hamartoma

目的分析19例鼻腔呼吸道上皮腺瘤样错构瘤(respiratory epithelial adenomatoid hamartoma,REAH)的临床特点。方法回顾性分析我科经病理证实的19例鼻腔REAH,分析其临床、影像及病理学资料。结果 19例患者临床症状与慢性鼻窦炎及鼻息肉症状相似,其中8例有鼻内镜手术史。17例患者新生物位于双侧嗅区,2例位于鼻中隔。17例鼻窦CT示双侧鼻腔嗅区可见软组织呈膨胀性生长,鼻窦内可见不同程度的炎症表现,2例鼻窦CT示鼻中隔孤立肿物。结论 REAH的临床症状缺乏特异性,但该病并不少见,因其有独特的影像学及病理表现,所以临床医师应充分认识该病并术中取材准确,可以提高其诊断率及治愈率,降低术后复发。

OBJECTIVE To describe and analyze the clinical features of the respiratory epithelial adenomatoid hamartoma(REAH) in nasal cavity.METHODS The clinical data of 19 cases of REAH in nasal cavity confirmed by pathology in our department from January of 2009 to September of 2010 were retrospectively studied.RESULTS The clinical symptom of these 19 cases were similar to the chronic sinusitis or nasal polyps and no specific symptoms.8 cases had past history of endoscopic sinus surgery(FESS).During the operation,pink tumors were found at bilateral olfactory cleft in 17 cases and at nasal septum in2 cases.Sinus CT of the 17 cases showed soft tissue image at bilateral olfactory cleft which grew expansively,and different degree of inflammation in sinus cavity.The other two cases showed soft tissue image in nasal septum.All the patients were underwent endoscopic sinus surgery to remove the tumors.CONCLUSION The clinical symptoms of REAH are nonspecific,and clinical and pathological doctors have very limited knowledge of it.But this disease is not rare.It has special images and pathologic features.So if clinical doctors can fully understand this disease and take the samples accurately in operation,we can increase the probability of diagnosis and cure rate,and reduce the postoperative recurrence.