Lau S K, Wei W I, Hsu C, Engzell U C
Department of Surgery, University of Hong Kong, Queen Mary Hospital.
Aust N Z J Surg. 1988 Dec;58(12):947-50. doi: 10.1111/j.1445-2197.1988.tb00098.x.
Fine needle aspiration biopsies of 42 histologically confirmed tuberculous cervical lesions were studied. Thirty-four patients had subsequent excision of cervical lymph nodes and eight had incision and drainage of cervical abscesses. All aspirates except two (which were inadequate) were satisfactory for diagnosis and contained inflammatory cells. Twenty-seven smears revealed cells typical of granulomatous lymphadenopathy, that is, epithelioid and multinucleated giant cells. Of all aspirates, 17 smears had bacteriological staining by Ziehl-Nielsen technique, nine of which (53%) were positive for acid-fast bacilli. An aspiration biopsy diagnosis of granulomatous or tuberculous cervical lymphadenopathy was made in 30 patients (71%). In regions where mycobacterial infection is common, the presence of granulomatous changes in lymph node aspirates is highly suggestive of tuberculosis. When the aspirates contain purulent material or when tuberculosis is suspected, staining and culture for mycobacteria should be performed. FNA biopsy is a sensitive, specific and cost-effective way to diagnose tuberculous cervical lymphadenopathy and is recommended.
对42例经组织学确诊的结核性颈部病变进行了细针穿刺活检研究。34例患者随后进行了颈部淋巴结切除，8例进行了颈部脓肿切开引流。除2例（标本不足）外，所有穿刺物均足以用于诊断且含有炎性细胞。27份涂片显示出肉芽肿性淋巴结病的典型细胞，即上皮样细胞和多核巨细胞。在所有穿刺物中，17份涂片采用萋-尼氏技术进行了细菌学染色，其中9份（53%）抗酸杆菌呈阳性。30例患者（71%）经穿刺活检诊断为肉芽肿性或结核性颈部淋巴结病。在分枝杆菌感染常见的地区，淋巴结穿刺物中出现肉芽肿性改变高度提示为结核病。当穿刺物含有脓性物质或怀疑为结核病时，应进行分枝杆菌染色和培养。细针穿刺活检是诊断结核性颈部淋巴结病的一种敏感、特异且经济有效的方法，值得推荐。
