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腭部坏死性唾液腺化生1例及文献回顾OA

Necrotizing sialometaplasia of the palate:a case report and literature review

中文摘要英文摘要

目的 探讨坏死性唾液腺化生的临床特征、病理表现、诊断要点及鉴别诊断,为该病的诊断与治疗提供依据.方法 本研究已通过单位医学伦理委员会审查批准,并获得患者知情同意.回顾1例发生于右侧软硬腭交界处的坏死性唾液腺化生患者资料,结合其临床表现、影像学及组织病理学的检查结果,综合分析其诊断过程,并对该病的相关文献进行复习回顾.结果 患者为24岁男性,既往有咀嚼槟榔史(半年余,2颗/d),口内检查见右侧软硬腭交界处一不规则弹坑状溃疡(3 mm×6 mm×5 mm),深达骨面.螺旋CT显示局部软组织缺损,周围骨质未见明显破坏.组织病理学提示黏膜及小唾液腺组织慢性炎症,未见恶性改变.最终诊断为坏死性唾液腺化生.经局部抗炎后,溃疡于就诊3周后完全愈合.文献复习结果表明,坏死性唾液腺化生是一种罕见的良性唾液腺疾病,好发于硬软腭交界处,多见于40~60岁的中年男性.其病因未明,目前普遍认为与机械刺激引发的局部缺血致唾液腺小叶梗死相关.因其临床表现近似恶性肿瘤,常被误诊.治疗以局部抗炎防腐促进愈合为主.结论 坏死性唾液腺化生是一种良性自限性疾病,临床表现与恶性肿瘤相似,易导致误诊.诊断需结合临床、影像及病理结果综合判断.治疗以保守对症为主.

Objective To enhance the recognition of necrotizing sialometaplasia(NS)by elucidating its clinical,pathological characteristics and key diagnostic points,providing a basis for the diagnosis and treatment of the disease.Methods This study has been reviewed and approved by the Medical Ethics Committee,and informed consent has been obtained from patients.Review the data of a patient with NS occurring at the junction of the right soft and hard palate,and comprehensively analyze its diagnostic process based on its clinical manifestations,imaging,and histopatho-logical examination results.And review the relevant literature on the disease.Results This study describes a 24-year-old male patient with a documented betel nut habit(2 pieces/day for>6 months),who presented with a bone-deep,ir-regular crateriform ulcer(3 mm×6 mm×5 mm)localized to the right hard-soft palate junction.Spiral CT showed a local soft tissue defect with no apparent underlying bone destruction.Histopathology demonstrated chronic inflammation of the mucosal and minor salivary gland tissues,with no evidence of malignancy.A final diagnosis of NS was estab-lished.The ulcer healed completely three weeks after initiation of local anti-inflammatory therapy.A literature review indicates that NS is a rare,benign salivary gland disorder,typically occurring at the hard-soft palate junction in middle-aged men(40-60 years).Its etiology remains unclear,but it is widely attributed to salivary lobe infarction following me-chanical trauma-induced ischemia.Due to its clinical resemblance to malignancy,it is often misdiagnosed.Treatment entails local anti-inflammatory measures and meticulous wound care aimed at promoting mucosal healing.Conclusion NS is a self-limiting,benign condition that poses a significant diagnostic challenge due to its close clinical simulation of malignancy.Thus,accurate diagnosis requires a combined assessment of clinical presentation,radiological features,and pathological findings.Treatment is predicated based on a conservative strategy with an emphasis on symptomatic man-agement.

布向文;叶传进;储志娟;段宁;王翔;王文梅;彭巧

南京大学医学院附属口腔医院,南京市口腔医院口腔黏膜病科,南京大学口腔医学研究所,江苏 南京(210008)南京大学医学院附属口腔医院,南京市口腔医院口腔病理科,南京大学口腔医学研究所,江苏 南京(210008)南京大学医学院附属口腔医院,南京市口腔医院口腔黏膜病科,南京大学口腔医学研究所,江苏 南京(210008)南京大学医学院附属口腔医院,南京市口腔医院口腔黏膜病科,南京大学口腔医学研究所,江苏 南京(210008)南京大学医学院附属口腔医院,南京市口腔医院口腔黏膜病科,南京大学口腔医学研究所,江苏 南京(210008)南京大学医学院附属口腔医院,南京市口腔医院口腔黏膜病科,南京大学口腔医学研究所,江苏 南京(210008)南京大学医学院附属口腔医院,南京市口腔医院口腔黏膜病科,南京大学口腔医学研究所,江苏 南京(210008)

医药卫生

口腔黏膜病坏死性唾液腺化生溃疡腭部自限性槟榔组织病理口腔恶性肿瘤

oral mucosal diseasesnecrotizing sialometaplasiaulcerpalateself-limitingbetel nuthis-topathologyoral malignant tumors

《口腔疾病防治》 2026 (3)

273-280,8

中国博士后科学基金项目(2023M741767) This study was supported by the grants from China Postdoctoral Science Foundation(No.2023M741767).

10.12016/j.issn.2096-1456.202550529

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