Tonsillar Tuberculosis Mimicking Tonsillar Malignancy- Case Report

類癌症表徵之扁桃腺結核—病例報告

陳浩慧(Hao-Hui Chen) ； 王成平(Cheng-Ping Wang) ； 張逸良(Yih-Leong Chang)

《台灣耳鼻喉頭頸外科雜誌》 52卷1期 (2017/03) Pp. 43-46

https://doi.org/10.6286/2017.52.1.43

摘要

Tonsillar tuberculosis is uncommon, but sometimes looks like tonsillar malignancy locally. We present a 55-year-old man with left sore throat and left upper neck mass for 2 weeks, but without symptoms such as fever, cough, or weight loss. Secondary tonsillar tuberculosis was diagnosed with typical tonsil pathology, positive culture of specimen for Mycobacterium tuberculosis and positive Chest X ray. After 6-month anti-tuberculosis medication, the tonsillar lesion and the left neck mass resolved. Care should be taken that the otolaryngologist must be familiar with the pictures of tonsillar tuberculosis and malignancy, and should consider tonsillar tuberculosis as one of the diagnoses of the lesions of tonsil, especially in patients in the countries where tuberculosis is endemic.

關鍵字

granulomatous inflammation ； tuberculosis ； tonsil ； tonsillar cancer

並列摘要

扁桃腺結核臨床上並不常見，局部視察看起來類似惡性病灶。本院收治1名55歲男性病患，主訴左側喉嚨痛及左側頸部腫塊約兩周，病患無發燒、咳嗽、體重減輕等症狀，局部發現左側扁桃腺表面潰爛有肉芽組織，左頸level II有一無法移動之硬塊，經抗生素治療1周無效後，扁桃腺切片病理診斷為結核菌感染，AFS及培養結果均為陽性，胸部X光呈現miliary pattern。經過6個月的抗生素治療，扁桃腺及頸部病灶均消失。因此病例相對少見，故提出報告，在視診扁桃腺時，如病灶看起來像惡性表現，也需將結核菌感染放入鑑別診斷，尤其是在結核菌的盛行區域。

並列關鍵字

granulomatous inflammation ； tuberculosis ； tonsil ； tonsillar cancer（肉芽腫性發炎 ； 結核 ； 扁桃腺 ； 扁桃腺癌）