Staub E, Jungi W F, Gloor F, Senn H J
Schweiz Med Wochenschr. 1981 Sep 5;111(36):1298-300.
Malignant neoplasms are quite frequently (5% in our material) first diagnosed from their metastases. Detecting the site of the primary usually involves a time-consuming and costly work-up unpleasant for the patient. In a retrospective analysis of 60 cases of supraclavicular, cervical and axillary lymph node metastases, an attempt is made to establish guidelines for more economical and rational investigation. The most important but often neglected leads are provided by history and physical examination. Routine laboratory and X-ray examinations only rarely contribute to rapid detection of the primary. Histological examination of the excised lymph node is very reliable in suggesting possible primaries. A practical guide is given for the approach to a patient with lymph node metastasis of an unknown primary, based on a limited initial work-up and on the histology of the lymph node.
恶性肿瘤相当常见（在我们的资料中占5%），最初是通过转移灶被诊断出来的。确定原发部位通常需要对患者进行耗时且昂贵的检查，这让患者很不舒服。在对60例锁骨上、颈部和腋窝淋巴结转移病例的回顾性分析中，我们试图制定更经济合理的检查指南。病史和体格检查提供了最重要但常被忽视的线索。常规实验室和X线检查很少有助于快速发现原发灶。切除淋巴结的组织学检查在提示可能的原发灶方面非常可靠。基于有限的初始检查和淋巴结组织学，给出了针对不明原发灶淋巴结转移患者的实用诊疗指南。
