Differential diagnosis of early nasopharyngeal carcinoma

Differential diagnosis of early nasopharyngeal carcinoma? The common sites and gross morphology of nasopharyngeal carcinoma are: nasopharyngeal carcinoma often occurs at the top of the posterior wall of the nasopharynx, followed by the side wall, and rarely occurs at the front wall and bottom wall. The gross morphology of nasopharyngeal carcinoma is divided into five types, namely nodular type, cauliflower type, submucosal type, invasive type and ulcerative type.

Its differential diagnosis

(I) Adenoid hyperplasia: Common in children and adolescents with adenoid constitution. The top of the nasopharynx. The pharyngeal tonsils are enlarged, and the mucosa is normal. When there is a high degree of hyperplasia or ulceration on the surface or granuloma-like formation, pay attention to cancer. A biopsy should be performed.

(ii) Nasopharyngeal inflammation: Common mucosal roughness, abundant secretions, uneven surface, most follicles proliferate into nodules of 0.2-0.3 cm in size, purple-red and sometimes orange-yellow, often accompanied by nasal mucosal inflammation, laryngitis, sinusitis and proliferation of lymphoid tissue in the posterior pharyngeal wall in the form of small nodules. It can be treated with heat-clearing, sore throat, blood circulation and stasis-removing methods.

(III) Benign nasopharyngeal tumors: rare. Long course of disease. They often occur in the front of the neck and are round or lobed with a smooth surface, such as fibroma, fibroangioma, mixed tumor, chordoma, etc.

(IV) Cervical lymphadenitis: Acute lymphadenitis caused by common pathogens is usually red, swollen, hot, painful, and with increased local temperature, often accompanied by oral and pharyngeal infection lesions. White blood cell count increases. Neutrophil count is high. Lymph nodes are mildly or moderately swollen, smooth, soft and active, tender and with clear borders. Anti-inflammatory treatment is effective. Chronic nonspecific lymphadenitis. Regardless of whether the cervical lymphadenitis is caused by bacteria or viruses, the local skin color is normal and the body temperature is not high. Tenderness is not obvious. It is often the size of a soybean or a broad bean. It is smooth, tough, active, and has clear edges. It often changes with the severity of inflammation in the pharynx, oral cavity, and ear. Anti-inflammatory treatment is often not ideal.

(V) Nasopharyngeal tuberculosis: Rare, most patients present with discomfort in the nasopharynx and a foreign body sensation. Increased secretions are often associated with tuberculosis of other organs, such as pulmonary tuberculosis.

(VI) Malignant lymphoma: It has an acute onset and a short course. It is more common in adolescents. The lesions may involve the entire nasopharyngeal cavity. It is common to see widespread enlargement of bilateral or other lymph nodes. The texture is softer and more elastic than metastatic lymph nodes. Pathological examination is often required for differential diagnosis in clinical practice.

(VII) Nasopharyngeal necrotizing granuloma: It is characterized by granular necrosis with clear borders in the center of the top of the nasopharynx and a special odor. The clinical course is similar to that of undifferentiated nasopharyngeal carcinoma.