Friedrich R E, Schmelzle R
Klinik für Mund-, Kiefer- und Gesichtschirurgie, (Nordwestdeutsche Kieferklinik, Universitäts-Krankenhaus Eppendorf.
Ultraschall Med. 1996 Oct;17(5):253-6. doi: 10.1055/s-2007-1003192.
Sonography following Radiochemotherapy for Undifferentiated Nasopharyngeal Carcinoma:
An undifferentiated nasopharyngeal carcinoma (UCNT) recurred 5 1/2 months after radiochemotherapy in a 14-year-old Caucasian boy. By ultrasound, multiple lymph nodes, predominantly left sided, were identified both in groups and singly located adjacent to large cervical vessels.
After lymphadenectomy, pathological examination revealed caseation necrosis with epitheloid cells and Langhans [corrected] cells in 2 of 6 enlarged lymph nodes (> 10 mm). The tentative diagnosis of tuberculosis was excluded during (3 years) follow-up.
Caseation necrosis in lymph node metastases is highly characteristic of UCNT. Sonography failed in the case described to demonstrate differences in lymph nodes with and without caseation necrosis. Differential diagnosis between tuberculous and metastatic cervical lymph nodes must therefore be made by other means (serology, microbiology).
一名14岁白种男孩在放化疗后5个半月，未分化鼻咽癌（UCNT）复发。通过超声检查，发现多个淋巴结，主要位于左侧，成群或单个位于颈部大血管旁。
淋巴结切除术后，病理检查显示6个肿大淋巴结（>10毫米）中有2个出现干酪样坏死，伴有上皮样细胞和朗汉斯[校正后]细胞。在（3年）随访期间排除了结核病的初步诊断。
淋巴结转移中的干酪样坏死是UCNT的高度特征性表现。在所描述的病例中，超声未能显示有干酪样坏死和无干酪样坏死的淋巴结之间的差异。因此，必须通过其他方法（血清学、微生物学）对结核性和转移性颈部淋巴结进行鉴别诊断。
