- 期刊
以下頜下區腫塊表現的Burkitt's淋巴瘤
Burkitt's Lymphoma Presenting as Submandibular Mass
摘要
Burkitt's淋巴瘤在臨床上的表現以腹腔腫瘤形式出現最多，約佔50%以上；而頭頸部則是第二常見的區域。但是非洲型（流行區域）在頭頸部區域的表現則不同於美洲型（點發性區域）。非洲型（流行區域）則是以最常侵犯到頜部為主，約佔60-70%；而美洲型（點發性區域）在下巴區域的表現則只佔12.5-16%。病患為14歲女性，主訴右側頸部有一疼痛性、質地堅硬且固定不動之快速腫大的腫塊約2週，詳細的物理檢查發現除了右側下頜下區域有輕微紅腫熱痛外，在口腔內並無任何的膿性分泌物出現，經初步診斷為右側下頜下腺發炎。經抗生素治療後，患者臨床症狀並未獲致改善，懷疑可能是下頜下腺的良性或惡性腫瘤，於是安排電腦斷層檢查，發現在右側下頜下腺區域呈現一同質性之腫塊，雖然頸部淋巴轉移也是懷疑之一，但因無原發部位可被發現，所以直接做切除式切片檢查，省略了Fine needle aspiration。病理報告結果為Burkitt's淋巴瘤。對於Burkitt’s淋巴瘤以下頜下腺及其他淋巴結腫大為最初的臨床表徵，實為一罕見的病例。臨床上對於下頜下腺腫大之病人，經抗生素治療無效時，宜建議須進一步評估以排除惡性腫瘤或其他疾病之可能性。由於罕見，故提出此病例。
並列摘要
Burkitt's lymphoma often appears in the abdominal cavity, but the head and neck are the second most common region. This paper documents a case encountered in April, 2004. The patient was a 14 year old female with an ache in the submandibular region of her right neck. The tumor was hard and motionless. It quickly swelled over the next two weeks after a preliminary diagnosis of right submandibular sialoadenitis. Initial treatment was with antibiotics, but the patient's clinical symptoms showed no improvement, and it was therefore suspected that a benign or malignant tumor was present in the submandibular gland. Radiography found a homogenous dense mass in the submandibular gland of right neck, and a surgical operation was conducted to excise the tissue. The pathology report identified Burkitt's lymphoma. The primary clinical presentations of Burkitt's lymphoma as submandibular gland enlargement and lymphoadenopathy are rather uncommon. Therefore, with regard to patients with such swellings, if antibiotic treatment is ineffective, it is suggested that malignant tumors should be suspected.
延伸閱讀
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