Rao Chalapathi A S, Rana Surinder S, Bhasin Deepak K, Nada Ritambhra, Sampath Santosh, Mittal Bhagwant R, Sharma Vishal, Dhaliwal Harpal S, Singh Kartar
Department of Gastroenterology (Chalapathi A.S. Rao, Surinder S. Rana, Deepak K. Bhasin, Vishal Sharma, Harpal S. Dhaliwal, Kartar Singh).
Histopathology Department (Ritambhra Nada).
Ann Gastroenterol. 2012;25(2):167-169.
Malignancies can metastasize through hematogenous or lymphatic routes. Enlarged lymph nodes in a known case of malignancy do not always imply metastasis. A middle-aged female patient presented to us with abdominal pain and jaundice. Investigation revealed ampullary growth due to adenocarcinoma. Positron emission tomography-computerized tomography scan revealed uptake of the tracer in the ampullary region as well as in enlarged mediastinal lymph nodes. Endoscopic ultrasound-guided fine needle aspiration cytology of the mediastinal lymphadenopathy revealed it to be tuberculous. Mere radiologic evidence of a distant nodal spread must not be regarded as final evidence and obtaining a tissue diagnosis should be strongly considered, as potentially curative therapy may be offered.
恶性肿瘤可通过血行或淋巴途径转移。在已知恶性肿瘤病例中，肿大的淋巴结并不总是意味着发生了转移。一名中年女性患者因腹痛和黄疸前来就诊。检查发现是壶腹腺癌。正电子发射断层扫描-计算机断层扫描显示示踪剂在壶腹区域以及肿大的纵隔淋巴结中摄取。纵隔淋巴结肿大的内镜超声引导下细针穿刺细胞学检查显示为结核。仅仅影像学上远处淋巴结转移的证据不应被视为最终证据，应强烈考虑进行组织诊断，因为可能会提供潜在的治愈性治疗。
