單側扁桃腺肥厚中的放射菌菌落－病例報告

Actinomyces in Unilateral Tonsillar Hypertrophy: A Case Report

10.6200/TCMJ.2014.11.3.09

陳建志(Jiann-Jy Chen)；張馨丰(Hsin-Feng Chang)；陳登郎(Dem-Lion Chen)

放射菌菌落 ； 扁桃腺肥厚 ； 帆咽閉鎖不全 ； actinomyces ； tonsillar hypertrophy ； velopharyngeal insufficiency

北市醫學雜誌

11卷3期（2014 / 09 / 30）

86 - 91

繁體中文

在成人不對稱扁桃腺中發現惡性腫瘤的機會為40.2%，因此，臨床上遇到這類病患均應建議手術切除或切片。－32歲男性，無反覆發作扁桃腺炎之病史，因進食時會逆流入鼻腔2個多月，求診於本院；理學檢查發現左側扁桃腺第4級腫大，經手術切除後，組織病理顯示為正常的扁桃腺組織，但在某一病理切面中發現了位於扁桃腺隱窩中的放射菌菌落。目前共有7篇英文文獻討論放射菌菌落是否會引起扁桃腺肥厚、反覆發作之扁桃腺炎、扁桃腺隱窩炎與扁桃腺切除術後出血，本個案之該側扁桃腺肥厚有可能就是該放射菌菌落所引起，卻也有可能僅是發育異常，而放射菌菌落僅是恰巧被發現正寄居於其隱窩中的腐生菌而已。

A malignant rate of 40.2% has been reported in patients with adult asymmetrical tonsils. Tonsillectomy or tonsillar biopsy is recommended for these patients. A 32-year-old male with presentation of velopharyngeal insufficiency for over two months and without a history of recurrent tonsillitis visited our hospital. A grade IV hypertrophy of right tonsil was noted. Post-tonsillectomy histopathology revealed a normal tonsil tissue, but an actinomyces colony was identified in a tonsillar crypt on a pathological section. Seven English articles have elucidated if actinomyces may cause tonsillar hypertrophy, recurrent tonsillitis, cryptitis and post-tonsillectomy hemorrhage. Actinomyces may be attributable to the unilateral tonsillar hypertrophy of our patient. It is also possible that the tonsillar hypertrophy was simply a developmental anomaly and the actinomyces a type of saprophytes living in the crypt by chance.