45例舍格伦综合征伴发唾液腺肿物误诊病例分析

Review and analysis of misdiagnosis of Sj?gren’s syndrome with salivary gland mass

目的:分析舍格伦综合征(Sj?gren’s syndrome,SS)伴发唾液腺肿物误诊病例的特点,为临床诊断提供参考。方法:回顾分析45例接受腮腺下颌下腺肿物切除术并最终病理诊断为良性淋巴上皮病患者的相关临床资料,并与唾液腺肿瘤性疾病进行对比分析。采用Microsoft Excel构建数据库并做统计分析。结果:45例患者均为女性,24.4%的患者累及双侧唾液腺,少数患者有口干(11.1%)、眼干(4.4%)、易疲劳(6.7%)、关节疼痛(22.2%)等临床症状,近半数患者肿物质地中等(55.6%),活动度小(53.3%)。35例患者接受CT检查,13例(37.1%)提示自身免疫性疾病,15例接受B超检查,13例接受MRI检查,分别有8例(53.3%)和10例(76.9%)提示自身免疫性疾病。结论:以唾液腺肿物为主诉就诊的中年女性,特别是肿物累及双侧的患者,需密切排除SS后再进行手术治疗。B超及MRI可作为CT以外的附加临床常规检查,用于唾液腺肿物的初期诊断。

PURPOSE:The characteristics of Sj?gren’s syndrome(SS)with misdiagnosis of salivary gland masses were analyzed to provide reference for clinical diagnosis.METHODS:This study retrospectively analyzed the clinical data of45 patients who underwent parotid/submandibular gland tumor resection and had a final pathological diagnosis of benign lymphoepithelial disease,and compared with salivary gland tumor diseases.Microsoft excel was used to build a database and perform statistical analysis.RESULTS:All involvement 45 patients were female,24.4%of the patients had bilateral salivary glands,a small number of patients complained dry mouth(11.1%),dry eyes(4.4%),easy fatigue(6.7%),joint pain(22.2%)and other clinical symptoms,nearly half of the patients had moderate mass texture(55.6%)and low mobility(53.3%).Among 35 patients who received CT examination,13(37.1%)reported the possibility of autoimmune diseases;15(53.3%)received B ultrasound examination,and 13(76.9%)received MRI examination.The reports of 8(53.3%)and 10(76.9%)patients respectively suggested the possibility of autoimmune diseases.CONCLUSIONS:For middle-aged women with salivary gland tumor as the chief complaint,especially those with bilateral involvement of the tumor,SS should be excluded before surgery.B-ultrasound and MRI can be used as additional clinical routine examinations in addition to CT for the initial diagnosis of salivary gland tumor.