喉結想以往相當常見,而且常合併肺部疾病又高傳染性。自抗結核藥發展以來,喉結核的臨床表徵在近幾十年內有了很大的改變。隨著胞結核發生率的下降,喉結核也顯示同樣的下降傾向。喉結核的臨床表現目前更為多樣化了,偶爾病人會表現出類似喉癌的症狀。我們遭遇一個喉結核的病例,其獨特的臨床表徵極類似上喉癌。嗄聲、前頸部硬塊、上喉部腫瘤狀鼓出,而且胸部X光正常,初步診斷為喉癌。組織病理證實是結核感染,而且有抗酸桿菌存在。患者接受抗結核藥治療,反應良好。當處理喉部病變及頸部腫瘤的病例時,喉結核應列入鑑別診斷。
Laryngeal tuberculosis was common in the past and usually accompanied by advanced pulmonary diseases. With the advent of effective antitubercu-lous chemotherapy, the clinical presentation now has a wider variety. Occa-sionally, patients with laryngeal tuberculosis may present with the symptoms and signs as laryngeal cancer. We encountered a case of laryngeal tuberculo-sis with unique clinical pictures simulating those of supraglottic laryngeal cancer. Hoarseness and a mass hard in consistency over the thyrohyoid memebrane with supraglottic tumefaction led to a tentative diagnosis of supraglottic laryngeal cancer. Chest X-ray was normal. Histopathologic study proved the diagnosis of tuberculosis with identification of the acid-fast bacilli. Antituberculous chemotherapy was given with an excellent response. In management of patients with either neck mass or laryngeal lesion, differ-ential diagnosis concerning laryngeal tuberculosis deserves special mention.