Winkelbauer F, Denk D M, Ammann M, Karnel F
Universitätsklinik für Radiodiagnostik, Universität Wien.
Ultraschall Med. 1993 Feb;14(1):28-31. doi: 10.1055/s-2007-1005210.
Lymph node tuberculosis is the most frequent tuberculous manifestation in the otorhinolaryngological area. In 13 patients with histologically verified tuberculous lymphadenitis cervical sonographic examinations revealed characteristic findings. The sonographic features typical for this disease were multiple, enlarged, conglomerating roundish and oval lymph nodes. These lymph nodes were hypoechoic, exhibited dorsal sound amplification and had sharp margins. With caseation, however, there were blurred borders. In cold abscesses an inhomogeneous texture with inhomogeneous shadows was found. Differential diagnosis included non-specific abscess-forming lymphadenitis, lymph node metastases and malignant lymphoma. A tentative diagnosis of cervical lymph node tuberculosis may be made due to the polymorphous sonographic pattern if history and clinical findings are taken into account. A proper histological and microbiological work-up is still essential for confirmation of the sonographic diagnosis.
淋巴结结核是耳鼻喉科领域最常见的结核表现形式。在13例经组织学证实的结核性淋巴结炎患者中，颈部超声检查发现了特征性表现。该病典型的超声特征为多个肿大、聚集的圆形和椭圆形淋巴结。这些淋巴结呈低回声，后方回声增强，边界清晰。然而，出现干酪样变时，边界则模糊不清。在寒性脓肿中，可发现质地不均匀且有不均匀回声。鉴别诊断包括非特异性脓肿形成性淋巴结炎、淋巴结转移瘤和恶性淋巴瘤。如果考虑病史和临床表现，由于超声图像的多形性，可初步诊断为颈部淋巴结结核。要确诊超声诊断，仍需进行适当的组织学和微生物学检查。
