Tsuji Tadataka, Satoh Koichi, Nakano Hiroshi, Nishide Yoshiya, Uemura Yasuhiro, Tanaka Susumu, Kogo Mikihiko
Department of Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan; First Department of Oral and Maxillofacial Surgery, Graduate School of Dentistry, Osaka University, 1-8 Yamadaoka, Suita City, Osaka, 565-0871, Japan.
Department of Oral and Maxillofacial Surgery, Saiseikai Matsusaka General Hospital, 15-6 Asahimachi 1-ku, Matsusaka City, Mie, 515-8557, Japan.
J Craniomaxillofac Surg. 2015 Dec;43(10):2200-4. doi: 10.1016/j.jcms.2015.09.010. Epub 2015 Oct 8.
Enlargement of cervical lymph nodes is required for early and accurate diagnosis of malignant lymphoma (ML). Lymph node biopsy is still indispensable for accurate diagnosis of lymph node enlargement in the lateral neck.
We retrospectively investigated the characteristics of lymph nodes on both ultrasonography (US) and computed tomography (CT), and blood biomarkers including serum thymidine kinase (TK) and soluble interleukin-2 receptor (sIL-2R) in 19 patients who underwent cervical lymph node biopsy.
Pathological diagnosis was ML in 8 patients, reactive lymphadenopathy (RL) in 8, and purulent lymphadenitis (PL) in 3. TK levels were significantly higher in patients with ML than in patients with RL, demonstrating positive correlations with sIL-2R and lymph node size on CT image. The shape of lymph nodes on US in all of the 8 patients diagnosed with RL was flat, whereas the shape in 7 of 8 patients diagnosed with ML was round. Lymph node size ≥19.5 mm at an axial section on CT image was used as a cut-off value to differentiate ML from other pathologies, offering 90.9% sensitivity and 87.5% specificity.
Sonographic and CT evaluation combined with high TK level might be useful in determining the need for early biopsy.
颈部淋巴结肿大对于恶性淋巴瘤（ML）的早期准确诊断至关重要。对于颈部外侧淋巴结肿大的准确诊断，淋巴结活检仍然不可或缺。
我们回顾性研究了19例行颈部淋巴结活检患者的超声（US）和计算机断层扫描（CT）检查的淋巴结特征，以及包括血清胸苷激酶（TK）和可溶性白细胞介素-2受体（sIL-2R）在内的血液生物标志物。
病理诊断为ML者8例、反应性淋巴结病（RL）者8例、化脓性淋巴结炎（PL）者3例。ML患者的TK水平显著高于RL患者，并与sIL-2R及CT图像上的淋巴结大小呈正相关。8例诊断为RL的患者中，所有患者US检查显示淋巴结呈扁平状，而8例诊断为ML的患者中，7例呈圆形。以CT图像轴位层面淋巴结大小≥19.5mm作为区分ML与其他病变类型的截断值，其敏感性为90.9%，特异性为87.5%。
超声及CT评估联合高TK水平可能有助于确定早期活检的必要性。
