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超声引导下穿刺活检对获得性免疫缺陷综合征患者合并淋巴结肿大的病因诊断价值 被引量:4

Pathological analysis of lymphadenopathy in patients with acquired immunodeficiency syndrome accompanied by interventional ultrasound
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摘要 目的:经超声引导下穿刺活检分析获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者合并淋巴结肿大的病因。方法:对2017年4月至2020年12月在上海市公共卫生临床中心行超声引导下穿刺活检的130例AIDS合并淋巴结肿大患者的病理诊断及实验室指标等进行回顾性分析,进而分析超声引导下穿刺活检对该类患者淋巴结肿大病因的诊断价值。结果:130例患者中,最终诊断良性病变82例(63.1%),包括淋巴结核56例,非结核分枝杆菌感染7例,马尔尼菲篮状菌感染6例,坏死性淋巴结炎5例,隐球菌感染2例,巨细胞病毒感染2例,金黄色葡萄球菌感染、淋巴组织增生、淋巴囊肿、EB病毒感染各1例;恶性肿瘤36例(27.7%),包括淋巴瘤17例(其中弥漫大B细胞淋巴瘤、Burkitt淋巴瘤各5例,浆母细胞淋巴瘤、小淋巴细胞性淋巴瘤及间变大细胞淋巴瘤各1例,另4例未分型),转移性肿瘤17例,卡波西肉瘤2例;病因类型不明确12例,其中病理检查提示11例为良性病变、1例为肿瘤性坏死。130例患者淋巴结肿大病因总诊断率达90.8%。所有患者无并发症。结论:超声引导下穿刺活检对AIDS合并淋巴结肿大患者淋巴结肿大病因诊断率高,且微创安全,对于该类患者淋巴结肿大临床早期诊断及精准治疗具有较高价值,值得临床推广应用。 Objective:To explore the diagnostic value of ultrasound-guided needle biopsy in acquired immunodeficiency syndrome(AIDS)accompanied with lymphadenopathy.Methods:From Apr.2017 to Dec.2020,130 patients with AIDS accompanied with lymphadenopathy underwent ultrasound-guided needle biopsy in the Shanghai Public Health Clinical Center.The clinical data and pathological diagnosis were retrospectively analyzed,and the diagnostic value of ultrasound-guided needle biopsy for etiologies of lymphadenopathy was analyzed.Results:Among the 130 patients,82(63.1%)and 36(27.7%)cases were diagnosed as benign lesions and malignant ones,respectively.The pathological types of benign lesions were as follows:56 lymphatic tuberculosis,7 non-tuberculous mycobacteria infections,6 marneffei infections,5 necrotizing lymphadenites,2 cryptococcus infections,2 cytomegalovirus infections,1 staphylococcus aureus,1 lymphoid tissue hyperplasia,1 lymphocyst,and 1 Epstein-Barr virus infection.The pathological types of the malignant lesions were as follows:17 lymphomas(5 diffuse large B-cell lymphomas,5 Burkitt lymphomas,1 plasmablastic lymphoma,1 small lymphocytic lymphoma,1 anaplastic large cell lymphoma,and 4 unclassified lymphomas),17 metastatic malignant tumors,and 2 Kaposi sarcoma,and 12 were undefined(11 patients were considered as benign lesions and 1 case was considered as tumor necrosis).Therefore,the diagnostic rate of ultrasound-guided needle biopsy for lymphadenopathy in AIDS patients reached 90.8%,and no complications occurred.Conclusions:Ultrasound-guided needle biopsy has a high diagnostic rate in pathological types of lymphadenopathy in patients with AIDS.It is safe,minimally invasive,and of great value in the early diagnosis and precise treatment for lymphadenopathy in patients with AIDS,and is worthy of clinical application.
作者 刘建建 黄晶晶 张晖 马鑫 冯艳玲 武豆 施霞 陆清 LIU Jian-jian;HUANG Jing-jing;ZHANG Hui;MA Xin;FENG Yan-ling;WU Dou;SHI Xia;LU Qing(Department of Ultrasound, Shanghai Public Health Clinical Center, Shanghai 201508, China;Department of Ultrasound, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Department of Pathology, Shanghai Public Health Clinical Center, Shanghai 201508, China)
出处 《中国临床医学》 2021年第5期818-822,共5页 Chinese Journal of Clinical Medicine
基金 上海市科学技术委员会科研项目(18411970800).
关键词 介入超声 获得性免疫缺陷综合征 淋巴结 诊断 intervention ultrasound acquired immunodeficiency syndrome lymph node diagnosis
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