[Lymphoproliferative disorders of Waldeyer's ring].

Anales Espanoles De Pediatria Pub Date : 2002-10-01
M P Prim Espada, J I De Diego Sastre, D Hardisson Hernáez, M Patrón Romero, P Jara Vega, M C García Meseguer, J Larrauri Martínez
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Abstract

Objective: To investigate the incidence and characteristics of lymphoproliferative disorders of Waldeyer's ring in our pediatric patients.

Material and methods: We retrospectively reviewed 20 children under 14 years of age who underwent surgery in our department for adenoidectomy and/or tonsillectomy between 1 January 1996 and 30 November 2000. In non-immunocompromised children, surgical indication was the recent development of progressive unilateral tonsillar hyperplasia, and in immunocompromised patients indication was mainly the enlargement of adenoids and/or tonsils, although eradication of local Ebstein-Barr virus infection and recurrent acute tonsillitis were also indications.

Results: The mean age was 4.6+/-2.3 years (range: 16.9 months-13.9 years). Sixteen patients (80.0 %) were male. In the nine patients with unilateral hyperplasia, histopathological diagnosis was diffuse lymphoid hyperplasia. Of the 11 immunocompromised patients, 5 (45.5 %) had some type of lymphoproliferative disorder.

Discussion and conclusions: Lymphoproliferative disorders of Waldeyer's ring are relatively frequent in immunocompromised children who have undergone surgery of the adenoids and/or tonsils. Although no cases of unilateral hyperplasia of the tonsils were diagnosed in our series, tonsillectomy is indicated in patients with this diagnosis, independent of their immunological status.

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[瓦尔德耶氏环淋巴增生性疾病]。
目的:探讨小儿瓦尔德耶氏环淋巴细胞增生性疾病的发病率及特点。材料和方法:我们回顾性分析了1996年1月1日至2000年11月30日期间在我科接受腺样体切除术和/或扁桃体切除术的20例14岁以下儿童。在非免疫功能低下的儿童中,手术指征是最近出现的进行性单侧扁桃体增生,而在免疫功能低下的患者中,手术指征主要是腺样体和/或扁桃体的扩大,尽管根除局部Ebstein-Barr病毒感染和复发性急性扁桃体炎也是指征。结果:平均年龄4.6±2.3岁(16.9个月~ 13.9岁)。男性16例(80.0%)。9例单侧增生患者,病理诊断为弥漫性淋巴样增生。在11例免疫功能低下患者中,5例(45.5%)有某种类型的淋巴细胞增生性疾病。讨论和结论:瓦尔德耶氏环淋巴增生性疾病在接受腺样体和/或扁桃体手术的免疫功能低下儿童中相对常见。虽然在我们的研究中没有诊断出单侧扁桃体增生的病例,但扁桃体切除术适用于诊断为单侧扁桃体增生的患者,与患者的免疫状态无关。
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