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目的:加深对儿童鼻部肿瘤的发病情况、临床病理组织学及影像学特点的全面了解,提高临床诊断和鉴别诊断水平。方法:收集经活检或术后病理确诊的40例鼻部肿瘤患儿的资料,总结其临床特征、病理组织学及影像学特点。结果:良性肿瘤23例,恶性肿瘤17例。良性肿瘤以纤维血管瘤(7例)、毛细血管瘤(4例)及骨化纤维瘤(4例)为主;恶性肿瘤以淋巴瘤(10例)及胚胎型横纹肌肉瘤(3例)为主。10例病变主要位于鼻窦,7例病变局限于鼻腔或鼻前庭,8例鼻腔鼻窦均受累,10例病变位于鼻咽部和(或)后鼻孔,3例位于外鼻,2例位于鼻中隔。CT或MRI表现:骨质破坏13例,骨质吸收5例,14例累及邻近结构,6例伴颈部淋巴结肿大。结论:儿童鼻部肿瘤以淋巴瘤、纤维血管瘤、毛细血管瘤、骨化纤维瘤和胚胎型横纹肌肉瘤较常见,其临床症状不典型,诊断及鉴别诊断主要依靠病理及影像学检查,CT和MRI能很好地显示肿瘤的部位、周围骨质改变情况和邻近结构侵犯,对肿瘤的临床诊断、分期、治疗方案的制定及预后评估具有重要意义。
OBJECTIVE: To deepen the comprehensive understanding of the pathogenesis of nasal neoplasms, clinicopathological and histological features and imaging features of children and improve the clinical diagnosis and differential diagnosis. Methods: The data of 40 cases of nasal tumor diagnosed by biopsy or postoperative pathology were collected and their clinical features, histopathology and imaging features were summarized. Results: 23 cases of benign tumors, 17 cases of malignant tumors. Malignant tumors were mainly fibroadenoma (7 cases), capillary hemangioma (4 cases) and ossification fibrosa (4 cases). Malignant tumors were mainly lymphoma (10 cases) and embryonal rhabdomyosarcoma (3 cases) . Ten lesions were mainly located in the paranasal sinuses, and seven lesions were confined to the nasal cavity or nasal vestibule. Eight cases of nasal sinus were involved. Ten lesions were located in the nasopharynx and / or posterior nostril. Three were located in the nasal cavity and two in the nasal septum. CT or MRI manifestations: 13 cases of bone destruction, bone absorption in 5 cases, 14 cases involving adjacent structures, 6 cases with cervical lymph node enlargement. Conclusion: The nasal tumors in children with lymphoma, fibrosarcoma, capillary hemangioma, ossifying fibroids and embryonal rhabdomyosarcoma are more common, and their clinical symptoms are not typical. The diagnosis and differential diagnosis mainly depend on pathology and imaging examination, CT and MRI can show the location of the tumor, the surrounding bone changes and adjacent structures, which is of great significance for clinical diagnosis, staging, treatment plan development and prognosis evaluation.