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目的:分析误诊为神经系统疾病的鼻咽癌患者的临床表现,病理改变及误诊原因。方法:对20例误诊为神经系统疾病的鼻咽瘤患者进行回顾性调查,其中14例行活体组织病理检查,6例行鼻咽部CT和/或MRI平扫加增强。结果:头痛是鼻咽癌患者最早期和最常见的症状(占80%),其次为复视(占50%)、耳闭塞感、听力减退和鼻衄(各占40%)等。病理类型以未分化癌(50%)和鳞状细胞癌(43%)居多。鼻咽部CT/MRI检查有利于鼻咽癌的早期诊断。结论;鼻咽部检查应作为可疑病例的一种常规检查,同时取活检,以提高鼻咽癌的早期诊断率。
Objective: To analyze the clinical manifestations, pathological changes and misdiagnosis of patients with nasopharyngeal carcinoma misdiagnosed as nervous system diseases. Methods: Twenty patients with nasopharyngeal carcinoma who were misdiagnosed as neurological diseases were investigated retrospectively. Among them, 14 cases were examined by biopsy and 6 by nasopharyngeal CT and / or MRI scan combined with MRI. Results: Headache was the earliest and most common symptom of nasopharyngeal carcinoma (80%), followed by diplopia (50%), ear occlusion, hearing loss and epistaxis (40% each). Pathological types are mostly undifferentiated carcinoma (50%) and squamous cell carcinoma (43%). Nasopharyngeal CT / MRI is helpful for the early diagnosis of nasopharyngeal carcinoma. Conclusion; Nasopharyngeal examination should be used as a routine examination of suspicious cases, and biopsy to improve the early diagnosis of nasopharyngeal carcinoma.