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[颈部淋巴结细针穿刺活检的诊断准确性:580例研究]

[Diagnostic accuracy of fine needle aspiration biopsy of cervical lymph node: a study of 580 cases].

作者信息

Sun Hai-Bin, Zheng Xiao-Fu, Zhang Jian

机构信息

Department of Pathology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2008 Oct;37(10):693-7.

Abstract

OBJECTIVE

Study on the diagnostic accuracy of fine needle aspiration biopsy of cervical lymph nodes and to discuss the reasons of making a misdiagnosis.

METHODS

Five hundred and eighty cases of cervical lymph node fine needle aspiration biopsy were reviewed retrospectively. Among them, histologic findings were available in 161 cases. The cytologic and histologic diagnoses were compared.

RESULTS

There were altogether 226 cases of reactive lymphoid hyperplasia, 202 cases of specific inflammation, 45 cases of malignant lymphoma and 107 cases of metastatic carcinoma. The concordance rate between the cytologic and corresponding histologic diagnoses was 94.4%. The primary foci of most cases with metastatic carcinoma could be delineated by reviewing the clinical and pathologic finding. Inadequate cellularity was the main reason of making misdiagnosis and useful diagnostic clues might be obtained by careful study of the clinical findings.

CONCLUSIONS

Fine needle aspiration biopsy of cervical lymph node carries a high diagnostic accuracy. It provides important clues in guiding subsequent clinical management. However, for detailed subtyping of certain disease entities such as malignant lymphoma, surgical biopsy for histologic and immunohistochemical studies are required.

摘要

目的

研究颈部淋巴结细针穿刺活检的诊断准确性,并探讨误诊原因。

方法

回顾性分析580例颈部淋巴结细针穿刺活检病例。其中161例有组织学检查结果,对细胞学和组织学诊断进行比较。

结果

共有反应性淋巴增生226例、特异性炎症202例、恶性淋巴瘤45例、转移性癌107例。细胞学与相应组织学诊断的符合率为94.4%。通过回顾临床和病理表现,多数转移性癌病例的原发灶可得以明确。细胞数量不足是误诊的主要原因,仔细研究临床发现可能获得有用的诊断线索。

结论

颈部淋巴结细针穿刺活检具有较高的诊断准确性。它为指导后续临床治疗提供重要线索。然而,对于某些疾病实体如恶性淋巴瘤的详细亚型分类,需要进行手术活检以进行组织学和免疫组化研究。

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