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颈部淋巴结病的临床病理相关性:一项基于医院的研究。

Clinico-pathological correlates of cervical lymphadenopathy: a hospital based study.

作者信息

Biswas Gautam, Das Anjan, Haldar Dibakar, Mukherjee Ankur, Dutta Sirshak, Sinha Ramanuj

机构信息

Department of Otolaryngology, R. G. Kar Medical College & Hospital, 35, Arunachal, Sodepur, Kolkata, 700110 India ; Department of Otolaryngology, Calcutta National Medical College & Hospital, Entally, Kolkata, India.

Department of Pathology, Calcutta National Medical College & Hospital, A/1, Rameswar Apartment, 29-31 Sankar Sarani, Howrah, 711205 India.

出版信息

Indian J Otolaryngol Head Neck Surg. 2013 Jul;65(Suppl 1):42-7. doi: 10.1007/s12070-011-0443-z. Epub 2012 Jan 6.

Abstract

Neck is the most common site of peripheral lymph node enlargement and is very frequently encountered in oto-laryngological practice. This study was done to delineate distribution of clinico-demographic parameters in patients presenting with cervical lymphadenopathy in the otolaryngology out-patient department of a state hospital in India in a 1 year period and to correlate them with fine needle aspiration cytological diagnosis. Record-based cross sectional study in the department of Otolaryngology and department of Pathology, Calcutta National Medical College and Hospital, Kolkata. Case reports and cytological reports of 423 patients who underwent Fine Needle Aspiration Cytology (FNAC) of cervical lymph nodes between January 2009 and December 2009 were reviewed in relation to their demographic and clinical profiles. The cases were divided into three groups according to age and different parameters were described according to these groups. In the cyto-pathological diagnosis, tubercular lymph-adenitis was most prevalent diagnosis (45.4%). Among the metastatic secondaries, squamous cell carcinoma was most common (8.5%). Non-specific/reactive lymphadenitis was significantly more common in <14 years, TB lymph node in 15-59 years and malignancy among the ≥60 years age group. Jugulo-omohyoid (level III) and Supraclavicular (level VB) groups of Lymph nodes were found significantly more involved by malignancy whereas Jugulo-diagastric (level II), Post-auricular, Submandibular groups (level IB) were more commonly involved in TB. Malignancy patients presented late in respect to the tuberculosis patients. Knowledge about clinico-demographic perspectives of cervical lymphadenopathy in respect to their cytopathological diagnosis will help care giver practioners to detect/refer the respective cases early for investigations and treatment.

摘要

颈部是外周淋巴结肿大最常见的部位,在耳鼻喉科临床实践中经常遇到。本研究旨在描述印度一家国立医院耳鼻喉科门诊在1年期间出现颈部淋巴结病患者的临床人口统计学参数分布,并将其与细针穿刺细胞学诊断结果相关联。在加尔各答国立医学院及医院的耳鼻喉科和病理科进行基于记录的横断面研究。回顾了2009年1月至2009年12月期间423例接受颈部淋巴结细针穿刺细胞学检查(FNAC)患者的病例报告和细胞学报告,涉及他们的人口统计学和临床特征。根据年龄将病例分为三组,并根据这些组描述不同参数。在细胞病理学诊断中,结核性淋巴结炎是最常见的诊断(45.4%)。在转移性继发性肿瘤中,鳞状细胞癌最常见(8.5%)。非特异性/反应性淋巴结炎在<14岁组中明显更常见,结核性淋巴结炎在15 - 59岁组中常见,而≥60岁年龄组中恶性肿瘤常见。颈内静脉肩胛舌骨肌组(Ⅲ区)和锁骨上组(ⅤB区)淋巴结发现恶性肿瘤累及明显更多,而颈内静脉二腹肌组(Ⅱ区)、耳后组、下颌下组(ⅠB区)更常受累于结核。恶性肿瘤患者比结核病患者就诊晚。了解颈部淋巴结病在细胞病理学诊断方面的临床人口统计学观点将有助于护理从业者尽早发现/转诊相应病例进行检查和治疗。

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