Sayın Ibrahim, Bişkin Sultan, Cakabay Taliye Tuncer, Yazıcı Zahide Mine, Meriç Ayşenur, Kayhan Fatma Tülin
Bakirköy Dr. Sadi Konuk Eğitim ve Araştirma Hastanesi, Kulak Burun Boğaz Hastaliklari Kliniği, Istanbul, Turkey.
Kulak Burun Bogaz Ihtis Derg. 2010 Jul-Aug;20(4):184-90.
In this study, we evaluate tuberculosis (Tbc) lymphadenitis diagnosed patients age, gender, contact history, history of smoking, socioeconomic status, lymphadenitis localization, imaging techniques, fine needle aspiration biopsy (FNAB) and excisional biopsy results.
Between February 2006 and February 2008 104 patients were operated to determine the etiology of their neck masses. Twenty-six patients (16 females, 10 males; mean age 36.9 years; range 16 to 52 years) who were diagnosed as Tbc lymphadenitis according to pathology results were included in the study. Ear, nose and throat examinations were performed in all patients routinely. Hemogram, biochemical and serological tests were performed. The patients were evaluated with anterior-posterior chest radiographs and purified protein derivative (PPD) by chest diseases consultation imaging methods and FNAB was performed. All patients diagnosed with excisional biopsy of neck mass. During the operation, tissue culture and Ziehl-Neelsen method for staining was prepared.
Out of 26 patients eight had a history of contact with Tbc. One person had previously lung Tbc. Six patients had previously received treatment because of Tbc lymphadenitis, but didn't complete the treatment. Neck ultrasonography and neck computed tomography detected a solid mass in 16 patients and cystic mass in 10 patients. The 24 patients were evaluated as positive PPD (>10 mm). None of the patients had an association between active pulmonary Tbc and Tbc lymphadenitis.
Suspicion is the most important step in the diagnosis of Tbc lymphadenitis. In patients with low socioeconomic status, previous Tbc contact, tabacco usage, suppressed immune system, and particularly in those with drainage from neck masses, Tbc lymphadenitis should be considered in the differential diagnosis.
在本研究中，我们评估了诊断为结核性淋巴结炎患者的年龄、性别、接触史、吸烟史、社会经济状况、淋巴结炎定位、成像技术、细针穿刺活检（FNAB）及切除活检结果。
2006年2月至2008年2月期间，对104例患者进行手术以确定其颈部肿块的病因。根据病理结果诊断为结核性淋巴结炎的26例患者（16例女性，10例男性；平均年龄36.9岁；范围16至52岁）纳入本研究。所有患者均常规进行耳鼻喉检查。进行血常规、生化及血清学检查。通过胸部疾病会诊成像方法对患者进行前后位胸部X线片及结核菌素纯蛋白衍生物（PPD）检测，并进行FNAB。所有患者均通过切除活检诊断颈部肿块。手术过程中，准备组织培养及萋-尼氏染色法。
26例患者中有8例有结核接触史。1人曾患肺结核。6例患者曾因结核性淋巴结炎接受治疗，但未完成治疗。颈部超声和颈部计算机断层扫描检测到16例患者为实性肿块，10例患者为囊性肿块。24例患者PPD检测为阳性（>10mm）。所有患者的活动性肺结核与结核性淋巴结炎之间均无关联。
怀疑是结核性淋巴结炎诊断中最重要的步骤。对于社会经济地位低、既往有结核接触史、吸烟、免疫系统受抑制的患者，尤其是有颈部肿块引流的患者，鉴别诊断时应考虑结核性淋巴结炎。
