Buis Jaap, de Jongh Tjeerd O H
Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands.
Ned Tijdschr Geneeskd. 2011;155:A2652.
Enlarged lymph nodes occur frequently and imply a benign or systematic disorder. In primary care, only 1% of patients with an unexplained lymphadenopathy have a malignancy. In the case of unexplained lymphadenopathy the most important diagnostic dilemma is whether biopsy should be applied. In young patients the necessity of lymph node biopsy can be accurately predicted using the following parameters: abnormal chest X-ray; lymph node > 2 cm and ear, nose and throat symptoms. In adults the necessity of biopsy may be reliably predicted using the following parameters: age; lymph node tenderness; lymph node size; consistency, presence of supraclavicular lymph nodes and generalised pruritus.
淋巴结肿大很常见，提示良性或全身性疾病。在初级保健中，原因不明的淋巴结病患者中只有1%患有恶性肿瘤。对于原因不明的淋巴结病，最重要的诊断难题是是否应对淋巴结进行活检。对于年轻患者，使用以下参数可准确预测是否需要进行淋巴结活检：胸部X光异常；淋巴结大于2厘米以及耳鼻喉症状。对于成年患者，使用以下参数可可靠地预测是否需要进行活检：年龄；淋巴结压痛；淋巴结大小；质地、是否存在锁骨上淋巴结以及全身性瘙痒。
