消化内镜检查发现下咽部淀粉样变性1例
A case of hypopharyngeal amyloidosis by digestive endoscopy
何玲 1苏薇 1李伶俐 1周巧 1赵秋灵 1李红平1
作者信息
- 1. 遵义医科大学附属医院消化病医院,遵义医科大学附属医院消化内科,贵州遵义 563000
- 折叠
摘要
淀粉样变性是一种罕见疾病.本文报告1例以肺结核为首发症状的局限性继发性下咽部淀粉样变患者.该患者缺乏特异性临床表现,主要表现为咳嗽、咳痰、反酸、嗳气、腹痛等症状,胸部CT提示支气管扩张伴感染及肺结核,消化内镜检查主要表现为下咽部右侧披裂处一白色黏膜隆起,病理诊断为下咽部黏膜组织内淀粉样物沉积.抗淀粉样蛋白A抗体阳性,刚果红染色(+)、过碘酸希夫染色(+).淀粉样变性最常累及消化系统,发生于消化系统的淀粉样变性病因多,且常与其他消化系统疾病的临床表现混淆,易漏诊和误诊,从而错过最佳的治疗时机.下咽部是消化道与呼吸道的共同通道,为高度皱襞化的狭窄腔隙性器官,消化内镜有助于发现中下咽部的淀粉样变性.
Abstract
Amyloidosis is a rare disease.This paper reports a case of localized secondary hypopharyngeal amyloidosis presenting with pulmonary tuberculosis as the initial symptom.The patient lacked specific clinical manifestations and primarily exhibited symptoms such as cough,sputum production,acid reflux,belching,and abdominal pain.Chest CT indicated bronchiectasis with infection and pulmonary tuberculosis.Digestive endoscopy revealed a white mucosal elevation at the right pyriform sinus of the hypopharynx.Pathological diagnosis confirmed amyloid deposits in the hypopharyngeal mucosal tissue.The patient tested positive for anti-amyloid A antibodies,Congo red staining(+),and periodate Schiff staining(+).Amyloidosis commonly affects the digestive system and may have various etiologies,often presenting with symptoms that overlap with other digestive system diseases,leading to frequent misdiagnosis and missed optimal treatment opportunities.The hypopharynx,a highly folded and narrow chamber that serves as a common passage for the digestive and respiratory tracts,can be effectively evaluated for amyloidosis using digestive endoscopy.
关键词
下咽部/淀粉样变性/消化内镜Key words
hypopharynx/amyloidosis/digestive endoscopy引用本文复制引用
基金项目
贵州省科技计划项目(黔科合基础-ZK2022一般 646)
出版年
2024
NETL
NSTL
万方数据