Jung W, Trümper L
Abteilung Hämatologie und Onkologie, Zentrum Innere Medizin, Universitätsmedizin der Georg-August-Universität Göttingen, 37099, Göttingen.
Internist (Berl). 2008 Mar;49(3):305-318; quiz 319-20. doi: 10.1007/s00108-008-2016-0.
Besides acute inflammatory swelling of a lymph node, acute lymphadenitis, enlarged lymph nodes occur in conjunction with various benign and malignant diseases. Lymphadenopathy can appear in a localized or generalized form and requires further diagnostic measures. Possible causes are primarily infectious, immunological, neoplastic, and metabolic disorders. The medical history and physical examination provide the first clues to the diagnosis. Localized swollen glands often have an infectious etiology so that the first step is to identify the possible focus of infection. Generalized lymphadenopathy is frequently a sign of a hematological systemic disease, particularly in adults. Therefore, in every case of lymphadenopathy persisting for more than 1 month, invasive diagnostic procedures are indicated to rule out a malignant cause. The aim should be to perform a histological analysis; excision of entire lymph nodes is exigent, especially for the work-up of lymphoma. In cases of malignant lymphoma, staging examinations should subsequently be conducted to assess the prognosis and formulate a treatment plan.
除了淋巴结的急性炎性肿胀（急性淋巴结炎）外，肿大的淋巴结还会与各种良性和恶性疾病同时出现。淋巴结病可呈局部或全身性，需要进一步的诊断措施。可能的病因主要是感染性、免疫性、肿瘤性和代谢性疾病。病史和体格检查为诊断提供了最初线索。局部肿大的淋巴结通常有感染性病因，因此第一步是确定可能的感染源。全身性淋巴结病常常是血液系统全身性疾病的体征，在成人中尤其如此。因此，在每一例持续超过1个月的淋巴结病病例中，都需要进行侵入性诊断程序以排除恶性病因。目标应该是进行组织学分析；完整切除淋巴结很迫切，特别是对于淋巴瘤的检查。对于恶性淋巴瘤病例，随后应进行分期检查以评估预后并制定治疗方案。
