- 期刊
Lymphoid Papillary Hyperplasia of the Palatine Tonsil-Case Report
顎扁桃體之淋巴樣乳頭狀增生－病例報告
摘要
Lymphoid papillary hyperplasia (LPH) is an exceedingly rare disease of the palatine tonsils. Most cases have been reported to affect East Asian girls, mainly in Japan. A 12-year-old girl was referred to our outpatient clinic for bilateral tonsillar neoplasms. She felt a lumpy sensation in the throat, with loud snoring noticed by her family for about 6 weeks. Physical examination revealed irregular dome-shaped polypoid projections from her bilateral palatine tonsils. Bilateral tonsillectomy was performed, and the histopathologic study confirmed this rare diagnosis. LPH usually manifests as snoring, a lumpy throat, and even obstructive sleep apnea. Histopathologically, the disease has a distinctive form of lymphoid hyperplasia with considerable distinct dome-shaped projections composed of many phyllodes containing remarkable follicular lymphoid hyperplasia. The exact mechanism is unclear. One case report implicated family pedigree1, but most of the reported cases were sporadic. Some causal factors mentioned include repeated inflammatory stimulation, hormonal influence, Epstein-Barr virus infection, and T-lymphocyte-mediated immune response, which possibly play a critical role. The disease is easily cured without recurrence through tonsillectomy. Herein, we report the first case of LPH of the palatine tonsils in Taiwan.
並列摘要
淋巴樣乳頭狀增生為一罕見之良性顎扁桃體腫瘤，好發於亞洲年輕女性，多數為日本病例報告。本病例為12歲女性，抱怨喉嚨異物感及打鼾約6週。門診檢查後發現雙側顎扁桃腺具不規則圓頂之乳頭狀腫瘤，施行雙側顎扁桃體切除術後，其病理報告為淋巴樣乳頭狀增生。淋巴樣乳頭狀增生臨床上常有喉嚨異物感、打鼾與呼吸中止症等表現。在組織病理學上，為獨特形式之淋巴樣增生，由許多包含濾泡性淋巴增生之圓頂狀突起所組成。致病機轉仍不明，曾有家族性病例報告，但大部分還是零星個案。有研究指出其與長期慢性發炎、荷爾蒙影響、及EB病毒感染相關，T細胞免疫反應尤其關鍵。治療方式為顎扁桃體切除術，目前無術後復發之案例報告。在此提出台灣第一例顎扁桃體之淋巴樣乳頭狀增生，作為扁桃腺疾病之鑑別診斷參考。