伴有坏死的颈部淋巴结增生性病变的临床病理探讨

Clinical Pathological Observation on Proliferative Lesions with Necrotic Cervical Lymph Nodes

目的探讨伴有坏死的颈部淋巴结增生性病变53例患者临床病理表现,以提高其诊治率。方法对安阳肿瘤医院2012年1月—2015年10月53例伴有坏死的颈部淋巴结增生性病变患者的临床病史、实验室检查、影像学检查及常规病理检查等进行回顾性分析。结果患者表现为颈部肿物,最大者长径0.5～4.5 cm。平均年龄43.17,女性多见。颈部淋巴结病理学改变：大体示单发或多发肿大淋巴结,切面灰白或灰黄;镜下表现主要包括：①凝固或非凝固性坏死;②上皮样细胞增生。多数病例进行了实验室及影像学检查。结论伴有坏死的颈部淋巴结增生性病变的病理表现仅具有相对特异性及提示性,需结合临床表现及其他辅助检查中方可确诊。因其临床表现易于转移性肿瘤及淋巴瘤等相似,因此病理及临床医师需提高对该类疾病的认识以减少漏诊及误诊。

Objective To observe the clinical pathological manifestations of 53 cases of patients with proliferative lesions with necrotic cervical lymph nodes in order to improve the diagnosis and treatment rate. Methods The clinical history, laboratory examination, imageological examination and conventional pathological examination of the patients with proliferative lesions with necrotic cervical lymph nodes treated in the Anyang Tumor Hospital from January, 2012 to October, 2015 were retrospectively analyzed. Results The patients manifested neck neoplasms, the long diameter of maximum was 0.5～4.5 cm,the average age was 43.17,and more common in female, pathological changes of cervical lymph nodes： single or multiple enlarged lymph nodes were in general, the cutting plane was grey or grey yellow; the manifestations under microscope mainly included①coagulation or non-coagulation necrosis ②epithelioid cell？proliferation, most cases received laboratory examination and imageological examination. Conclusion The pathologic manifestation of proliferative lesions with necrotic cervical lymph nodes only has relative specificity and warning, and it can be diagnosed combined with clinical manifestations and other auxiliary examinations, and the pathologic and clinical physicians need to improve the recognition of this kind of disease thus reducing the misdiagnosis and missed diagnosis because its clinical manifestations are easy to be similar to those of metastatic tumors and lymphoma.