Kenis Y
Acta Chir Belg. 1983 Mar-Apr;83(2):107-13.
Cervical lymph nodes are frequently involved in malignant lymphomas, especially in Hodgkin's disease. The surgeon who performs a lymph node biopsy should be aware of the technical problems concerning fixation, conservation, and transport of the surgical specimen in order to allow special immunologic and histochemical techniques, if there is a high degree of suspicion of malignant lymphoma. Staging laparotomy should be considered only if non invasive diagnostic methods have been non contributory and if the potential change in staging involves a change in treatment. Radiotherapy is the main part of the therapeutic strategy in stage I/II whereas chemotherapy is primarily considered for stage III/IV. Stage I/II, with B symptoms, with massive mediastinal involvement, and/or with a large number of nodal sites, may benefit from the combination of chemotherapy and radiotherapy. On the other hand, irradiation of residual disease after chemotherapy should be considered in disseminated disease.
颈部淋巴结常受累于恶性淋巴瘤,尤其是霍奇金病。进行淋巴结活检的外科医生应了解手术标本固定、保存及运输方面的技术问题,以便在高度怀疑恶性淋巴瘤时能采用特殊的免疫和组织化学技术。仅在非侵入性诊断方法无帮助且分期的潜在变化涉及治疗改变时,才应考虑进行分期剖腹术。放疗是Ⅰ/Ⅱ期治疗策略的主要部分,而Ⅲ/Ⅳ期则主要考虑化疗。有B症状、纵隔大量受累和/或有大量淋巴结部位的Ⅰ/Ⅱ期患者,可能从化疗与放疗联合中获益。另一方面,对于播散性疾病,应考虑对化疗后残留病灶进行照射。