• 제목/요약/키워드: Laryngeal tuberculosis

검색결과 36건 처리시간 0.018초

후두결핵의 임상양상과 진단 (Clinical Characteristics and Diagnosis of Laryngeal Tuberculosis)

  • 조현진;소윤경;손영익
    • 대한후두음성언어의학회지
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    • 제19권1호
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    • pp.43-46
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    • 2008
  • Background and Objectives : Clinical suspicion and appropriate diagnostic procedures are essential for the timely management of extrapulmonary type of mycobacterial disease. In the hope of suggesting a suitable guideline for the early diagnosis of laryngeal tuberculosis, the authors reviewed their clinical pathways and the characteristics of patients with laryngeal tuberculosis who were managed in the recent 10 years at a single tertiary referral hospital, Samsung Medical Center. Subjects and Method : Retrospective chart review was performed for the 25 adult patients with laryngeal tuberculosis. Among 25 cases, 12 were pathologically confirmed by laryngeal biopsy and the other 13 were clinically diagnosed by cumulative clinical information; definite laryngitis on laryngoscopy, positive AFB (acid fast bacillus) smear/culture or active pulmonary tuberculosis on chest X-ray, and substantial response to anti-tuberculosis medication. Results : Chest X-ray revealed active pulmonary tuberculosis in 72% of patients (N=18/25). Sputum AFB smear/culture was positive in 95% of all tested patients (N=21/22) and in 100% of the tested patients who have stable or no evidence of pulmonary tuberculosis (N=5/5). All patients except one who had coexisting laryngeal malignancy showed considerable improvement in their subjective symptoms and laryngeal findings within the first 2 months of anti-tuberculosis medications and they achieved complete response on subsequent sputum studies, chest X-ray and laryngeal findings after $7.0{\pm}2.3$ months of the medications. Conclusion : We suggest that chest X-ray and sputum AFB smear/culture to be the first step of work-up for the patients having laryngeal tuberculosis in suspicion since laryngeal tuberculosis is largely associated with active pulmonary tuberculosis and/or sputum AFB study offers high yield even in case of primary laryngeal tuberculosis. However laryngeal biopsy must be considered in case showing unsatisfactory response to the anti-tuberculosis medication for more than 2 months.

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후두종양의 임상적 및 병리학적 고찰 (The Clinical and Pathological Study of Laryngeal Mass)

  • 이원용;배정수;김혜숙;여재동;조세인
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1983년도 제17차 학술대회연제순서 및 초록
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    • pp.6.2-6
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    • 1983
  • 이비인후과 영역의 종양중 후두종양은 비교적 흔히 볼 수 있으며, 그 특이한 증상과 간접후두경 및 후두직달경 등으로 조기진단이 가능한 반면에 증상의 경과도 빨라 치명율 역시 높은 것이 사실이다. 이에 저자는 1978년 6월부터 1983 년 2월까지 본 병원에 내원하여 애성 및 후두종양을 발견한 108명의 환자를 임상적 및 병리학적으로 분류하여 문헌적 고찰과 함께 보고하는 바이다.

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장결핵과 동반된 기관지 내 및 후두 결핵 1례 (A Case of Intestinal Tuberculosis Concurring with Endobronchial and Laryngeal Tuberculosis)

  • 김수진;박수은;이민기;김건일;이창훈;박재홍
    • Clinical and Experimental Pediatrics
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    • 제46권7호
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    • pp.714-717
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    • 2003
  • 저자들은 설사와 체중 감소, 기침과 발열을 주소로 내원한 환아에서 장결핵과 기관지 내 결핵, 후두 결핵이 동반된 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

편측 성대발적 6례에 대한 임상적 고찰 (Unilaterally Injected Vocal Fold : Clinical Aspects in 6 Patients)

  • 최홍식;서진원;문형진;김광문
    • 대한후두음성언어의학회지
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    • 제8권2호
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    • pp.239-244
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    • 1997
  • 편측 성대발적을 보였던 6례중 후두결핵이 4례, 성문부 편평세포암이 1례. 만성 후두염이 1례였으며 각 후두질환에 대한 진단과 적절한 치료를 위해서는 후두생검을 통한 보다 적극적인 조직병리학적 확진이 필요함을 문헌고찰과 함께 보고하는 바이다.

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인후두결핵 1례 (A Case of Tuberculosis of the Pharynx and Larynx)

  • 진도순;양철민;채요한;이강온
    • 대한기관식도과학회지
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    • 제2권1호
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    • pp.140-144
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    • 1996
  • Despite the incidence of tuberculosis has been greatly reduced with chemotherpy, it is still a common disease in Korea. The pharyngeal and laryngeal tuberculosis usually result from direct contamination of the laryngeal or pharyngeal mucosa by sputum heavily laden with Mycobacterium tuberculosis, secondary infection from the lungs via lymphatic or hematogenous routes, or a primary affection from inhaled tubercle bacilli. Recently the authors experienced a pharyngolaryngeal tuberculosis and report this case with brief literatures review.

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급성 후두개염으로 오인된 결핵성 후두개염 1예 (A Case of Epiglottic Tuberculosis that Presented as Acute Epiglottitis)

  • 이동훈;김재영;정기홍;이준규
    • 대한두경부종양학회지
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    • 제26권2호
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    • pp.247-249
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    • 2010
  • Laryngeal tuberculosis is very rare, but the most common sites of laryngeal lesions include true vocal cords and false vocal cords. The major symptoms of laryngeal tuberculosis are hoarseness, dysphagia, and cough. Epiglottic tuberculosis has rarely been reported. We experienced one case of epiglottic tuberculosis that presented as acute epiglottitis and report it with reviews of literature.

후두 결핵의 임상 양상 분석: 최근 10년간 단일 기관의 경험 (Clinical Analysis of Laryngeal Tuberculosis: Recent 10 Years' Experience in a Single Institution)

  • 김지훈;공태훈;최홍식;변형권
    • 대한후두음성언어의학회지
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    • 제31권2호
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    • pp.61-65
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    • 2020
  • Background and Objectives The overall incidence of laryngeal tuberculosis (LT) has generally decreased over the recent years, yet there is still a discrete population of patients newly diagnosed with the disease. This study is aimed to examine the patients with LT over the recent 10 years and to investigate the changes in clinical pattern with respect to the past period. Materials and Method A retrospective review has been performed on 20 patients who have been initially diagnosed with LT between 2005 and 2015. Results The age of the patients ranged from 25 years to 95 years with an average age of 45.6 years. Seventeen patients (85%) showed hoarseness, which was the most common clinical symptom. Most affected lesion was the true vocal cord. Laryngoscopic examination showed various clinical manifestations: polypoid 30%, granulomatous 25%, nonspecific 25%, ulcerative 20%. A variety of methods were used for diagnostic confirmation of LT [acid-fast bacilli (AFB) smear 45%, AFB culture 40%, polymerase chain reaction 30%, surgical pathology 45%]. Coexisting pulmonary tuberculosis (PT) was detected in 10 patients (50%). Relative to the patients with inactive PT or normal lung status, those with active PT showed higher incidence of laryngeal lesions located in areas other than true vocal cord (p=0.050). Conclusion Based on the analytic results from this study, laryngologists should recognize the changes in the recent clinical patterns of LT and always be ready for clinical suspicion of this disease on such atypical laryngeal findings which can often mimic laryngeal malignancies to provide the pertinent treatment.

후두 결핵의 후두 내시경 소견과 임상 양상 분석 (The Telescopic Findings and Clinical Manifestations of Laryngeal Tuberculosis)

  • 이상혁;이승석;이노희;반재호;이경철;진성민
    • 대한후두음성언어의학회지
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    • 제17권1호
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    • pp.38-42
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    • 2006
  • Background and Objectives: There has been a gradual decline in the incidence of laryngeal tuberculosis due to effective an-tituberculous chemotherapy and improvement in the standard of living. During the last decade, however, the disease has changed its clinical pattern. We aimed to study a clinical and telescopic evaluation of laryngeal tuberculosis. Materials and Method: A retrospective clinical analysis was done for 16 patients who diagnosed laryngeal tuberculosis from January 2000 through December 2004. All patients had a complete clinical and laboratory work-up including telescopy, chest X-rays, sputum cultures, Tbc PCR(polymerase chain reaction). Laryngeal biopsies were performed in some cases. All the patients received proper antituberculous chemotherapy. Results: The patients age ranged from 21 to 59 with a mean age 43. The male to female ratio was 10:6. The prominent presenting symptom was hoarseness. The various telescopic findings were categorized: 7 patients showed ulcerative, 4 patients granulomatous, 3 patients ulcerofungative, 2 patients had nonspecific inflammatory lesions. Involving sites were true vocal cord most commonly in 12 patients. Three of 16 patients had normal chest X-ray fmding. Among 16 patients, 4 patients showed positive response for AFB stain, 13 patients showed positive for Tbc PCR. Biopsy was done for 3 patients who were not confirmed in initial tuberculous test. All patients responded satisfactorily to antituberculous medication. Conclusion: The telescopic findings and clinical manifestations of laryngeal tuberculosis have changed and seemed to be different from those of classic reports. Thus, the clinicians who deal with the various symptoms and diseases should be aware of the existence of laryngeal tuberculosis and the changing patterns of the disease.

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후두 종양의 임상적 및 병리조직학적 고찰 (The Clinical and Histopathological Study of Laryngeal mass)

  • 김화성;한경수;이준기;정덕희;박재훈
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1981년도 제15차 학술대회연제순서 및 초록
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    • pp.9.1-10
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    • 1981
  • 1975년 3月부터 1980년 3月까지 애성을 주소로 하여 본원에 입원하여 수술 받은 183명의 후두 종양 환자에 대한 임상적 통계와, 그중 병리조직학적으로 확진된 88case의 성대 결절과 폴립 환자에서, 성대 결절(30case), 국한성 폴립 (48), 미만성 폴립 (10)을, 임상적인 분류하에 현미경학적 검사로 다음과 같은 결과를 얻었기에 보고하는 바이다. I. 임상적 관찰 1) 전체 183명중 성대 결절 82명 (45%), 후두 폴립 53명 (29%), 삽관후 육아종 3명 (1%), 후두 유두종 18명 (10%), 후두 결핵 2명 (1%), 후두암 25명 (14%)를 차지했다. 2) 남녀 비는 성대 결절 3 : 4, 후두 폴립은 1 : 1, 삽관후 육아종 1 : 2, 후두 유두종 3 : 2, 후두암 11 : 1.성대 결절, 삽관후 육아종은 여자, 후두암과 후두 유두종은 남자에게 많았다. 3) 연령 분포는 성대 결절 20~30대, 후두 폴립 30~40대, 삽관후 육아종 20대, 후두 결핵 10대와 40대, 후두암은 50대이었다. 4) 증상발현으로부터 내원까지의 이환기간의 분포를 보면 성대 결절과 폴립은 5개월~1년, 후두 유두종과 삽관후 육아종은 1년이내, 후두 결핵과 암은 1년~3년이었다. 5) 발생 부위를 보면, 성대 결절, 폴립 후두 유두종은 성대의 전 1/3~중 1/3경계, 삽관후 육아종은 중 1/3~후 1/3, 이었다. 6) 발생측에 있어서 후두 결절과 유두종은 성대의 양측에 오며, 후두 폴립 5 : 3, 삽관후 육아종 2 : 1로 우측에 많았다. 7) 후두 종양의 크기는, 성대 결절 1~2mm(67%), 후두 폴립 3~5mm(42%), 삽관후 육아종 6~10mm(67%), 후두 유두종 1~2mm(39%), 후두 결핵과 암은 10mm 이상의 크기로 산재해 있었다. 8) 후두 종양의 증상은 애성이 90%이상, 연하통은 후두암과 결핵, 호흡곤란은 삽관후 육아종, 후두 유두종, 결핵, 암에서 나타났으며, 그외에 후두의 이물감, 작열감, 소양감 둥의 증상이 있었다. 9) 과거력은 Smoking과 관련 있는 것이 후두 결핵 50%, 후두암 40%이었고, 후두 유두종은 빈번한 상기도 감염이 33%에서 있었다. 10) 직업에서는 어떤 특별한 통계학적 의미를 찾아볼 수 없었다. II. 병리조직학적 관찰 1) 성대 결절과 플립의 상피세포는 중층 편평 상피로 덮여 있으나, 위축, 극세포증, 이상 각화증과 과각화증의 소견을 보이며, 그중 과각화증과 극세포증이 많았다. 2) WHO classification에 의해 섬유성 점액 종양, 혈관성, 유리질성의 4가지 단계로 나누였는데, 성대결절은 점액 종양 병변 60%, 국한성 폴립은 점액 종양 병변과 함께 혈관성, 유리질성 병변이 많았고, 미만성 폴립은 혈관성 병변(80%)이었다. 3) 전 18례의 후두 유두종에서, Exophytic 형이며 편평세포형이 17례(94.5%), 역형이며 이행세포형이 1례 (5.5%)이었다. 4) 후두암은 편평세포 : 선암의 비율이 24 : 1이었다.

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