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本文报告一例原发性鼻咽结核。患者主诉右颈部隆起一个月,既往有反复咽痛史。检查见右颈部二腹肌区淋巴结肿大6×4cm,质硬,无压痛,活动差,但未与胸锁乳突肌粘连,左颈部二腹肌区淋巴结轻微增大,无压痛。检查鼻咽顶、右侧壁交界处粘膜呈不规则溃疡,然无出血和分泌物。两周后右颈部肿大之淋巴结中央变软。入院后行鼻咽溃疡部活检,病理显示多数典型郎罕氏巨细胞和干酪样坏死,证实为结核性肉芽组织;
This article reports one case of primary nasopharyngeal tuberculosis. The patient complained of an uplift of the right neck for one month and had a history of repeated sore throats. Examination revealed that the lymph nodes in the diverticulum of the right neck were 6×4cm in size, hard, no tenderness, and poor in motion, but did not adhere to the sternocleidomastoid muscle. The lymph nodes in the digastric muscle area of the left neck increased slightly and there was no tenderness. The mucosa at the junction of the nasopharyngeal top and the right side of the wall was irregularly ulcerated, but there was no bleeding or discharge. After two weeks, the lymph nodes in the right neck became swollen. After admission, a biopsy of the nasopharyngeal ulcer was performed. The pathology revealed that most of the typical Langerhans giant cells and caseous necrosis were confirmed as tuberculous granulation tissue.