Lang Stephan, Kansy Benjamin
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Essen, Germany.
GMS Curr Top Otorhinolaryngol Head Neck Surg. 2014 Dec 1;13:Doc08. doi: 10.3205/cto000111. eCollection 2014.
The lymph nodes are an essential part of the body's immune system and as such are affected in many infectious, autoimmune, metabolic and malignant diseases. The cervical lymph nodes are particularly important because they are the first drainage stations for key points of contact with the outside world (mouth/throat/nose/eyes/ears/respiratory system) - a critical aspect especially among children - and can represent an early clinical sign in their exposed position on a child's slim neck. Involvement of the lymph nodes in multiple conditions is accompanied by a correspondingly large number of available diagnostic procedures. In the interests of time, patient wellbeing and cost, a careful choice of these must be made to permit appropriate treatment. The basis of diagnostic decisions is a detailed anamnesis and clinical examination. Sonography also plays an important role in differential diagnosis of lymph node swelling in children and is useful in answering one of the critical diagnostic questions: is there a suspicion of malignancy? If so, full dissection of the most conspicuous lymph node may be necessary to obtain histological confirmation. Diagnosis and treatment of childhood cervical lymph node disorders present the attending pediatric and ENT physicians with some particular challenges. The spectrum of differential diagnoses and the varying degrees of clinical relevance - from banal infections to malignant diseases - demand a clear and considered approach to the child's individual clinical presentation. Such an approach is described in the following paper.
淋巴结是人体免疫系统的重要组成部分，因此在许多感染性、自身免疫性、代谢性和恶性疾病中都会受到影响。颈部淋巴结尤为重要，因为它们是与外界接触的关键点（口腔/咽喉/鼻子/眼睛/耳朵/呼吸系统）的第一级引流站——这在儿童中尤为关键——而且在儿童纤细的颈部暴露在外的位置上，它们可能是早期临床体征。淋巴结在多种病症中的受累伴随着大量可用的诊断程序。为了节省时间、考虑患者的健康状况和成本，必须仔细选择这些程序，以便进行适当的治疗。诊断决策的基础是详细的病史采集和临床检查。超声检查在儿童淋巴结肿大的鉴别诊断中也起着重要作用，并且有助于回答关键诊断问题之一：是否怀疑有恶性肿瘤？如果是这样，可能需要对最明显的淋巴结进行完整切除以获得组织学确诊。儿童颈部淋巴结疾病的诊断和治疗给儿科和耳鼻喉科主治医生带来了一些特殊挑战。鉴别诊断的范围以及从普通感染到恶性疾病的不同临床相关性程度，要求针对儿童的个体临床表现采取清晰且经过深思熟虑的方法。以下论文将描述这样一种方法。
