兰州大学第二医院耳鼻咽喉头颈外科;
目的 探讨以复发性鼻部肿物为首发症状并误诊为血管瘤的木村病临床特点,增加对此病的认知以提高首次诊断率,降低误诊率。方法 回顾性分析2024年1月收治的1例曾误诊的木村病患者的临床资料,并对相关文献进行复习。结果 患者以复发性鼻背部皮下无痛性肿块为主要临床表现,外周血嗜酸粒细胞绝对值及百分比正常,B超检查提示血管瘤,通过2次鼻部肿物手术切除,最终经病理学检查诊断为木村病。从首次发病诊断为淋巴组织增生到二次复发后确诊,误诊时间长达3年余,预后良好,随访1年无复发。结论 木村病临床罕见,易误诊。组织病理学检查是该病诊断的金标准,影像学检查和血清IgE水平、外周血嗜酸粒细胞绝对值及百分比可协助诊断,手术切除是诊断及治疗的一种有效手段,血常规、尿常规、肾功能检测、血清IgE水平、局部超声检查可以作为随访过程中的监测指标,为后期治疗方案的制定提供参考。
38 | 0 | 14 |
下载次数 | 被引频次 | 阅读次数 |
[1] MAUPPIN C,OSIO A,DE MASSON A,et al.Eczema/prurigo as an unusual presentation of Kimura's disease[J].Ann Dermatol Venereol,2021,148(1):49-50.
[2] 李睿思,金航宇,玄云泽.木村病的诊断与治疗研究进展[J].延边大学医学学报,2023,46(4):344-346.
[3] 何宇,刘娟,马代远.木村病2例报道及文献复习[J].现代肿瘤医学,2022,30(14):2619-2621.
[4] STUCZYNSKI S K,MURAS-SZWEDZIAK K,NOWICKI M.Diagnostic challenges in Kimura's disease[J].Pol Merkur Lekarski,2022,50(296):128-130.
[5] PARK S W,KIM H J,SUNG K J,et al.Kimura disease:CT and MR imaging findings[J].AJNR Am J Neuroradiol,2012,33(4):784-788.
[6] 罗瑞,杨功鑫,石慧敏,等.头颈部木村病的影像学特征研究[J].上海交通大学学报(医学版),2024,44(9):1182-1189.
[7] 胡想想,李传应.临床误诊为脂肪肉瘤的腹股沟木村病1例报告[J].医药前沿,2024,14(4):76-78.
[8] 郝延召,王迪,邵依,等.木村病1例并相关文献复习[J].皮肤病与性病,2022,44(1):85-86,88.
[9] 王乔慧,韩建德,粟慧琳.木村病的治疗新进展[J].中国皮肤性病学杂志,2024,38(10):1068-1073.
[10] 陈辉树,陈华,张乃鑫,等.木村病38年伴发皮肤T细胞淋巴瘤一例[J].中华血液学杂志,2007,28(4):271-272.
[11] LI T J,CHEN X M,WANG S Z,et al.Kimura's disease:a clinicopathologic study of 54 Chinese patients[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,1996,82(5):549-555.
[12] 申卫东,王延林,赵建东,等.左耳后无痛性包块14年、左腮腺区肿物8年余、右侧耳后肿物5年余[J].中华耳科学杂志,2017,15(3):386-389.
[13] 卢小雪,笪倩.13例嗜酸性粒细胞增生性淋巴肉芽肿的临床特征、病理学表现及文献复习[J].诊断学理论与实践,2017,16(6):639-644.
[14] ZHANG X,JIAO Y.The clinicopathological characteristics of Kimura disease in Chinese patients[J].Clin Rheumatol,2019,38(12):3661-3667.
[15] VARSHNEY M K,KUMAR A,KHAN S A,et al.Kimura disease of extremity:unusual manifestation in a long bone[J].Joint Bone Spine,2008,75(4):492-494.
[16] 张小鸽,李志娟,陈国强,等.儿童木村病合并肾病综合征3例分析并文献复习[J].中国实用儿科杂志,2017,32(8):615-618.
[17] LIU L,ZHANG W,HUANG M,et al.The clinical and pathological features of Kimura disease in pediatric patients[J].Front Med (Lausanne),2024,11:1352206.
[18] 丁峰,刘春红,李兴福,等.木村病12例临床分析[J].中华风湿病学杂志,2007,11(4):225-228,插2.
[19] 林楠,高宁,蔡菁华,等.木村病17例临床病理分析[J].实用口腔医学杂志,2020,36(3):497-500.
[20] 邓维叶,高云飞,陈艳峰,等.Ki-67在木村病患者中的表达和复发相关因素分析[J].中山大学学报(医学科学版),2014,35(4):584-588.
[21] BUDER K,RUPPERT S,TRAUTMANN A,et al.Angiolymphoid hyperplasia with eosinophilia and Kimura's disease:a clinical and histopathological comparison[J].J Dtsch Dermatol Ges,2014,12(3):224-228.
[22] BOTTO E,RODRIGUEZ-WAITKUS P,ALBERS S E.Angiolymphoid hyperplasia with eosinophilia and Kimura disease:a case report and literature review[J].Pediatr Dermatol,2024,41(5):857-860.
[23] LEE C C,FENG I J,CHEN Y T,et al.Treatment algorithm for Kimura's disease:a systematic review and meta-analysis of treatment modalities and prognostic predictors[J].Int J Surg,2022,100:106591.
[24] NAGARAJ S,SINGH S N,SHARMA V K,et al.Kimura disease:a case report and review of literature[J].Indian J Otolaryngol Head Neck Surg,2022,74(Suppl 2):1850-1853.
[25] 张娟,姚亚男,温魏棋,等.木村病伴肾病综合征1例[J].标记免疫分析与临床,2024,31(4):773-775.
[26] WANG D Y,MAO J H,ZHANG Y,et al.Kimura disease:a case report and review of the Chinese literature[J].Nephron Clin Pract,2009,111(1):c55-61.
[27] REN S,LI X Y,WANG F,et al.Nephrotic syndrome associated with Kimura's disease:a case report and literature review[J].BMC Nephrol,2018,19(1):316.
[28] SAH P,KAMATH A,ARAMANADKA C,et al.Kimura's disease:an unusual presentation involving subcutaneous tissue,parotid gland and lymph node[J].J Oral Maxillofac Pathol,2013,17(3):455-459.
[29] IWAI H,NAKAE K,IKEDA K,et al.Kimura disease:diagnosis and prognostic factors[J].Otolaryngol Head Neck Surg,2007,137(2):306-311.
[30] WEN-CHIEH T,KUAN-HUI Y,LI-YU L,et al.Kimura's disease as a mimicker of cavernous hemangioma:a case report and literature review[J].Int J Rheum Dis,2024,27(1):e14858.
[31] 王俊广,王少春,杨斌.超声对木村病诊断及鉴别诊断价值的研究进展[J].影像研究与医学应用,2022,6(10):1-3.
[32] GOPINATHAN A,TAN T Y.Kimura's disease:imaging patterns on computed tomography[J].Clin Radiol,2009,64(10):994-999.
[33] 王子坤,冯晶晶,吴杰,等.MRI诊断腮腺木村病一例[J].磁共振成像,2022,13(5):124-125.
[34] ZHAO F,ZHOU M,MAO A,et al.Kimura disease:a detailed analysis of clinical and radiological manifestations in a retrospective case series[J].J Inflamm Res,2024,17:3371-3381.
[35] 唐瑾,原韶玲,苗润琴,等.颌面部木村病超声特征、临床特点分析并文献复习[J].中国临床医学影像杂志,2024,35(3):160-162,173.
[36] 赵琴,马步云,贾浥苹,等.颌面部木村病的超声表现[J].中国医学影像学杂志,2022,30(2):134-138.
[37] 易孝纯,毕锋,侯静.木村病的CT和MRI表现[J].实用放射学杂志,2022,38(2):196-199.
[38] 李国,王振平,袁利,等.木村病的影像表现及文献复习[J].实用放射学杂志,2017,33(4):510-512.
基本信息:
DOI:
中图分类号:R597
引用信息:
[1]丁文娟,刘龙燕,南书玲等.鼻根部木村病误诊分析及文献复习[J].临床误诊误治,2025,38(09):14-20.
基金信息:
甘肃省青年科技基金计划项目(21JR11RA119)