一种类似扁桃体淋巴瘤的恶性混合表型急性白血病

Q4 Medicine Polish Annals of Medicine Pub Date : 2022-04-04 DOI:10.29089/paom/147387
Nurul Syuhadah Hasny, Iu Tong Lim, S. Mohamad, N. A. Che Jalil, M. Hassan, I. Mohamad, N. Mat Lazim
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引用次数: 0

摘要

单侧扁桃体肥大并伴有宫颈淋巴结病变,最可能的诊断是淋巴瘤或鳞状细胞癌。我们的目的是强调诊断扁桃体切除术对完整扁桃体的作用,而不是对明显的真菌团块或溃疡性病变进行切口活检。我们也强调不要忽视异常的初步血液检查。如果出现白细胞增多,必须做外周血片以排除持续感染或更严重的血液学疾病。我们报告一例年轻女性表现为进行性吞咽困难以及双侧颈部肿胀。检查显示单侧扁桃体肥大,双侧颈部淋巴结高度提示扁桃体淋巴瘤。为了诊断和治疗目的,她选择了扁桃体切除术。左扁桃体切除的组织病理学检查(HPE)加上详细的血液检查,最终诊断为罕见的混合表型急性白血病。多学科团队的方法和早期干预是至关重要的,以达到正确的诊断,允许及时治疗和更好的预后和症状缓解。
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A sinister mixed phenotype acute leukemia mimicking tonsil lymphoma
Unilateral tonsillar hypertrophy with accompanying cervical lymphadenopathy gives immediate suspicion of lymphoma or squamous cell carcinoma as the most probable diagnosis.We aim to highlight the role of diagnostic tonsillectomy for intact looking tonsil as opposed to incisional biopsy for obvious fungating mass or ulcerative lesion. We also emphasise not to overlook abnormal preliminary blood work up. If leukocytosis is present, a peripheral blood film must be done to rule out ongoing infection or a more cynical haematological disease.We report a case of a young female presenting with progressive dysphagia as well as bilateral neck swelling. Examination showed a unilateral tonsillar hypertrophy with bilateral cervical lymph nodes highly suggestive of tonsil lymphoma.She was opted for tonsillectomy for both diagnostic as well as therapeutic purposes. Histopathological examination (HPE) of the left tonsil removed paired with an elaborated blood workup finally diagnosed her with a rare case of mixed phenotype acute leukemia.A multidisciplinary team approach and early intervention are crucial to arrive at the correct diagnosis allowing prompt treatment and better prognosis and symptomatic relief.
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来源期刊
Polish Annals of Medicine
Polish Annals of Medicine Medicine-Medicine (all)
CiteScore
0.40
自引率
0.00%
发文量
28
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