原发性喉淀粉样变性4例及文献回顾

Primary laryngeal amyloidosis: report of 4 cases and literature review

目的探讨原发性喉淀粉样变的临床特征及治疗方法。方法回顾性分析空军军医大学附属唐都医院2017年4月-2019年1月收治的喉淀粉样变4例临床资料,并进行相关文献复习。结果 4例患者病变组织均经手术切除,其中2例喉正中裂开肿物切除,2例支撑喉镜下二氧化碳激光手术切除,病理结果示淀粉样变,无喉气管功能损伤,无临床及实验证据表明有系统性淀粉样病变。随访时间3个月至2年,未见肿物复发。结论孤立性喉淀粉样变是一种罕见的良性肿瘤,需要同其他良恶性喉肿瘤相鉴别,治疗前需排除全身系统性淀粉样病变。治疗方案以手术为主,治疗策略应该偏保守,以保留器官功能为前提。

Objective To analyze the clinical features and treatment of primary laryngeal amyloidosis.Methods Clinical data of 4 patients with primary laryngeal amyloidosis surgically treated in our hospital between April 2017 and Jan 2019 were analyzed retrospectively, and relevant literatures were reviewed.Results Complete surgical removal of lesion was achieved in all the patients without laryngotracheal dysfunction. Of them, mass resection was performed via middle laryngeal fissure in 2 cases, CO2 laser removal under selfretaining laryngoscope in the other two. Postoperative pathological results confirmed the diagnosis of amyloidosis. No clinical and experimental evidences indicated systemic amyloidosis. Postoperative follow-up for 3 months to 2 years revealed no recurrence.Conclusion Isolated laryngeal amyloidosis is a rare benign tumor that should be differentiated from other benign and malignant laryngeal tumors. Systemic amyloidosis should be excluded before treatment. The main treatment strategy is surgery and should be conservative to preserve organ function.