以咽喉溃疡为主要表现的喉淋巴瘤2例及临床分析

Laryngeal lymphoma with laryngeal ulcer as the primary presentation: An analysis of two cases

摘要:

目的 探讨以咽喉溃疡为主要表现的喉淋巴瘤的临床特点，旨在提高喉淋巴瘤的诊疗水平。方法 回顾性分析湘雅常德医院2020年12月—2025年2月收治的2例喉淋巴瘤患者的临床资料，对其症状、 病程、病变部位、溃疡形态、诊疗经过及病理结果进行总结，并结合文献复习阐述该类疾病的临床特点。结果 2例患者分别为NK/T细胞淋巴瘤、T细胞淋巴瘤，症状以咽痛为主，病程均超过1个月，喉镜下可见多发片状溃疡、喉部黏膜充血肿胀，临床表现无明显特异性。结论 电子纤维喉镜检查以及窄带成像技术（NBI）对于喉部疾病的诊治有着重要的指导作用。对咽喉部多发性顽固性溃疡，需要对患者进行详细的病史采集、查体和专科检查，以及相关的实验室、影像学、病理学等检查。对病史较长或反复发作的溃疡，应尽早病理检查确诊，减少误诊漏诊。

Abstract:

Objective To investigate the clinical features of laryngeal lymphoma primary presenting with laryngeal ulcers, and to enhance its diagnostic and therapeutic efficacy. Methods A retrospective analysis was conducted on the clinical data of two patients diagnosed with laryngeal lymphoma,who were admitted to Xiangya Changde Hospital from December 2020 to February 2025. This analysis was encompassing clinical manifestations, disease course, involved anatomical sites, ulcer characteristics, diagnostic investigations, and histopathological examination. Additionally, an extensive literature review was performed to delineate the clinical characteristics of this disease category. Results Two patients, diagnosed with NK/T-cell lymphoma and T-cell lymphoma respectively, presented primarily with odynophagia, and both had a disease course beyond one month. Laryngoscopy reveals multifocal ulcerative lesions accompanied by mucosal erythema and edema. Conclusions Electronic fiber laryngoscopy and narrow band imaging (NBI) technology play a crucial guiding role in the diagnosis and treatment of laryngeal diseases. It is essential for the assessment of persistent pharyngolaryngeal ulcerative lesions by a comprehensive diagnostic algorithm encompassing meticulous history collection, complete physical examination, and multimodal investigations (incorporating hematologic analyses, advanced imaging modalities, and histopathologic evaluation). Expedited biopsy procurement is strongly recommended for chronic or recurrent ulcerations to achieve accurate histopathological confirmation, reduce misdiagnosis rates.