Koch T, Vollrath M, Reimer P, Milbrath H
HNO-Klinik, Medizinischen Hochschule Hannover.
HNO. 1989 Apr;37(4):144-7.
Thirty patients with a squamous cell carcinoma of the head and neck, with cervical lymph nodes which could be shown by ultrasound but not by palpation of the neck, are reviewed. The cervical lymphatic nodes, which were similar in size to the preoperative ultrasonic measurement, were removed by elective neck dissection. Histological examination showed a reactive inflammation only, without tumour infiltration, in 83.3% of the cases. These clinically inconspicious lymph nodes, which were homogeneous on ultrasound scan and could be easily differentiated from the background, obviously show the premalignant stage of tumour spread. The consequences for the operation and later follow-up are discussed.
回顾了30例头颈部鳞状细胞癌患者，其颈部淋巴结超声可显示但触诊未触及。通过选择性颈清扫术切除了与术前超声测量大小相似的颈部淋巴结。组织学检查显示，83.3%的病例仅为反应性炎症，无肿瘤浸润。这些在临床上不明显的淋巴结，在超声扫描中表现均匀，且易于与周围组织区分，显然显示出肿瘤扩散的癌前阶段。讨论了其对手术及后续随访的影响。
