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[原发性颈淋巴结结核的临床特征与治疗]

[Clinical characteristics and management of primary cervical tuberculous lymphadenitis].

作者信息

Sun Wenhai, Liu Huamin, Liang Dapeng

机构信息

Department of Otolaryngology, Affiliated Hospital of Medical College, Qingdao University, Qingdao 266003, China.

出版信息

Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2006 Jun;20(12):552-3.

Abstract

OBJECTIVE

To investigate the clinical characteristics and management of primary cervical tuberculous lymphadenitis.

METHOD

Thirty-two patients with primary cervical tuberculous lymphadenitis were reported, of which four patients were diagnosed definitely by fine needle aspiration cytology, twenty-eight patients were diagnosed definitely by incisional or excisional biopsy. Twenty-nine patients have been examined by computer tomography (CT) before biopsy. Twenty-seven patients got anti tuberculosis therapy for six months after the total masses resection or regional cervical lymph node dissection, while the others got general anti tuberculosis chemotherapy for one year.

RESULT

CT showed the iso-density enhancement or heterogeneous enhancement of the masses. All patients were followed up. After anti tuberculosis therapy for three months, one patient was diagnosed as cervical tuberculous lymphadenitis combined with cervical lymph node metastasis of nasopharyngeal carcinoma and treated by radiotherapy in the department of oncology, the other thirty-one patients had no relapse and other manifestations of tuberculosis.

CONCLUSION

The characteristics of primary cervical tuberculous lymphadenitis have been changed, cervical masses localized mostly to the posterior cervical regions were the first and major clinical symptoms. CT examination will be helpful for the diagnosis and differential diagnosis of such disease. Primary cervical tuberculous lymphadenitis can be treated effectively with combination of standard anti tuberculosis chemotherapy and surgical excision of the cervical lymph nodes. Operations play an important role in the therapy of primary cervical tuberculous lymphadenitis, such as shortening the treatment period, reducing the dosage, noxious and side-effect of drugs and avoiding the forming of abscess or sinus.

摘要

目的

探讨原发性颈淋巴结结核的临床特点及治疗方法。

方法

报告32例原发性颈淋巴结结核患者,其中4例经细针穿刺细胞学检查确诊,28例经切开或切除活检确诊。29例患者在活检前行计算机断层扫描(CT)检查。27例患者在肿块全切或颈淋巴结区域清扫术后接受6个月抗结核治疗,其余患者接受1年常规抗结核化疗。

结果

CT显示肿块呈等密度强化或不均匀强化。所有患者均获随访。抗结核治疗3个月后,1例患者诊断为颈淋巴结结核合并鼻咽癌颈淋巴结转移,转肿瘤内科行放射治疗,其余31例患者无结核复发及其他表现。

结论

原发性颈淋巴结结核的特点发生了变化,以颈后部局限性肿块为首发及主要临床症状。CT检查有助于该病的诊断及鉴别诊断。原发性颈淋巴结结核采用标准抗结核化疗与颈淋巴结手术切除相结合可有效治疗。手术在原发性颈淋巴结结核治疗中起重要作用,如缩短治疗周期、减少药物用量、毒副作用,避免脓肿或窦道形成。

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