原文題目

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口腔病理科 On-Line KMU Student Bulletin

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原文題目(出處)： Panoramic Radiographic Appearance of Massive Calcification of Tuberculous Lymph Nodes

The Journal of Contemporary Dental Practice 2008;9:108-14 原文作者姓名： M.Isa Kara; Define Yeler; Hasan Yeler; Sinan Ay

通訊作者學校： Department of Oral and Maxillofacial Surgery of the Faculty of Dentistry at Cumhuriyet University in Sivas, Turkey.

報告者姓名(組別)：柯建佐(D)

報告日期： 97.10.21

內文：

Introduction

Tuberculosis is an infectious granulomatous disease, most commonly caused by

Mycobacterium tuberculosis, which remains a public health problem

worldwide.

Tuberculosis is classified as both pulmonary and extrapulmonary.

Tuberculosis of the lymph nodes is one of the most frequent forms of extrapulmonary tuberculosis.

Case Report

A 35-year-old man applied to our faculty clinic for extraction of his impacted third molar tooth.

Pano

Of interest were several massive, irregularly shaped, radiopaque lesions observed bilaterally on the radiograph.

The left side of the radiograph showed large,multiple, symptomless, radiopaque masses in the submandibular region,below the angle,

and adjacent to the vertebrae and mandibular angle.

CT

Computerized tomography (CT) revealed multiple calcified lymph nodes in the left submandibular and cervical areas.

The largest node was 2.5 cm in diameter.

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Palpation revealed hard, non-movable, non-tender nodules in the submandibular and cervical tissues.

The patient reported a history of severe inflammation in the tonsils when he was about 13-14 years old.

The patient’s tuberculin test was positive, and there was no abnormality found in the plain chest radiographic film.

Based on his past history and some diagnostic tests a diagnosis of tuberculous lymph node calcification was made.

Discussion

The role of the contrast CT scan is very important for an etiologic diagnosis of lymphadenopathy.

Tuberculosis calcification most frequently occurs in the chest and abdomen’s node.

As reported here, the widespread calcification in the submandibular and cervical lymph nodes are uncommon.

On panoramic radiographs, there are many kind of soft tissue calcifications that mimic lymph node calcifications

Identification of the position of the calcification in relation to the mandible is difficult using traditional radiographic techniques.

The calcified lymph node may be single or multiple,unilateral or bilateral, lying in a roughly linear orientation,and the periphery may be well defined and usually irregular,sometimes having a lobulated appearance resembling a cauliflower.

calcified lymph node and sialolith

Generally, the border of sialolith is smooth whereas calcified lymph node is commonly irregular or lobulated and patients with sialolith have symptoms related to the salivary gland.

Summary

Because treatment is unnecessary for symptomfree calcified lymph nodes and the

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patient in the present case was unwilling to any further

examination done, surgical removal of the calcified lymph nodes was not done.

題號題目

1 肺結核主要是由下列哪一種病菌引起的?

(A) Tannerella forsythia

(B) Mycobacterium tuberculosis

(C) Actinobacillus actinomycetemcomitans (D) Porphyromonas gingivalis

答案(B) 出處：Oral & maxillofacial Pathology 2^nd e P.173

題號題目

2 Which is the most common extrapulmonary sites in the head and neck?

(A) Nasal cavity

(B) Nasopharynx

(C) Cervical lymph nodes

(D) Oral cavity

答案(C) 出處：Oral & maxillofacial Pathology 2^nd e P.173