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韋氏肉芽腫病－病例報告
Wegene's Granulomatosis-Case Report
摘要
韋氏肉芽腫病為一臨床上少見的多發性系統疾病。本文報告一例26歲男性，初時臆斷為篩竇腫瘤合併左眼窩侵犯，經耳鼻喉科切片檢查，病理組織切片顯示為急、慢性發炎。但在疑似為韋氏肉芽腫病的診斷下，病患仍然接受數個療程之免疫抑制化學藥物治療；由於症狀持續復發，且加劇，始轉予眼科醫師（吳俊昇）施行下眼眶切開及腫瘤切除手術。組識病理學報告證實為韋氏肉芽腫病，終其病程未見腎臓器官受到侵犯。由於殘留腫瘤繼續增長，雖再經數次化學藥物及類固醇藥物治療，仍然危及周遭組織，最後亦由眼科醫師（吳俊昇）施行眼窩內容物剜除術(Exenteration)。術後迄今患者情況良好，未再復發。
關鍵字
無資料並列摘要
We present a case of 26-year-old male, patient with chief complaint of progressive painful proptosis of left eye for about one year. He received bilateral endoscopic intranasal polypectomy under the impression of ethmoid carcinoma with involvement of left orbit by ENT doctors. Pathological report disclosed only the picture of acute and chronic inflamation. From the clinical manifestations, Wegener's granulomatosis was highly suspected. After treatment with courses of cyclophosphamide and systemic steroid, the proptosis of left eye is still progressing. Finally removal of the orbital mass via inferior orbitotomy was performed and specimen was sent for histolopathological studies. Prominent vasculitis of various stages and necrosis as well as multiple nucleated giant cells, comparible with Wegener's granulomatosis are the main findings.
延伸閱讀
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