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單側扁桃腺肥厚中的放射菌菌落-病例報告

Actinomyces in Unilateral Tonsillar Hypertrophy: A Case Report

摘要


在成人不對稱扁桃腺中發現惡性腫瘤的機會為40.2%,因此,臨床上遇到這類病患均應建議手術切除或切片。-32歲男性,無反覆發作扁桃腺炎之病史,因進食時會逆流入鼻腔2個多月,求診於本院;理學檢查發現左側扁桃腺第4級腫大,經手術切除後,組織病理顯示為正常的扁桃腺組織,但在某一病理切面中發現了位於扁桃腺隱窩中的放射菌菌落。目前共有7篇英文文獻討論放射菌菌落是否會引起扁桃腺肥厚、反覆發作之扁桃腺炎、扁桃腺隱窩炎與扁桃腺切除術後出血,本個案之該側扁桃腺肥厚有可能就是該放射菌菌落所引起,卻也有可能僅是發育異常,而放射菌菌落僅是恰巧被發現正寄居於其隱窩中的腐生菌而已。

並列摘要


A malignant rate of 40.2% has been reported in patients with adult asymmetrical tonsils. Tonsillectomy or tonsillar biopsy is recommended for these patients. A 32-year-old male with presentation of velopharyngeal insufficiency for over two months and without a history of recurrent tonsillitis visited our hospital. A grade IV hypertrophy of right tonsil was noted. Post-tonsillectomy histopathology revealed a normal tonsil tissue, but an actinomyces colony was identified in a tonsillar crypt on a pathological section. Seven English articles have elucidated if actinomyces may cause tonsillar hypertrophy, recurrent tonsillitis, cryptitis and post-tonsillectomy hemorrhage. Actinomyces may be attributable to the unilateral tonsillar hypertrophy of our patient. It is also possible that the tonsillar hypertrophy was simply a developmental anomaly and the actinomyces a type of saprophytes living in the crypt by chance.

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