78例腋淋巴结转移瘤活检的病理学分析

目的　分析腋淋巴结转移瘤的病理学特点 ,为判断腋淋巴结来源未明转移瘤 (MUO)的可能原发部位提供参考性诊断思路。方法　对近 2 0年收验的 78例腋淋巴结转移瘤患者的性别、年龄、转移瘤原发部位进行一般性分析 ,并对其中已知原发瘤部位 (MKO)的 6 2例 (男 16例、女 46例 )患者年龄、受累及淋巴结侧位、转移瘤基本组织学类型等与原发瘤部位进行相关性分析。结果　 (1)约 1/ 5 (2 0 5 %)病例未知原发部位 ,男性病例的MUO率 (30 4 3%)显著高于女性 (14 18%) (P <0 0 5 )。(2 )女性患者的年龄总体上显著低于男性 ,并且年龄分布范围较广泛。 (3)男性和女性的转移瘤都主要为腺癌 (分别为47 83%和 83 6 4%) ,但女性显著高于男性 (P <0 0 1) ;男、女各自的腺癌与鳞癌之比分别为 1∶0 36和 1∶0 0 7。 (3)女性原发瘤部位的数目 (6处 )多于男性 (3处 )。 (5 )女性的 6处中 ,来自乳腺和肺者分别居于左侧或右侧的首位和次位 ,其他为食管、子宫内膜、子宫颈和腕部皮肤。 (6 )男性的 3处中 ,来自肺者皆居于左、右侧之首 ,其他为胃和食管。结论　女性腋淋巴结转移瘤主要来自局部引流区域 ,以乳腺为主 ,占 82 6 6 %;男性转移瘤皆来自胸腔和腹腔等远处引流区域。提示腋淋巴结转移瘤 ,在男性主要考虑来自胸腔和腹

Pathological analysis of metastasis of axillary lymph node by biopsy in 78 cases

Purpose Some pathologic characteristics of metastatic tumors in axillary lymph nodes are analyzed to provide referenced diagnostic idea of speculating primary sites of metastatic tumors in axillary lymph nodes in metastasis of unknown origin(MUO). Methods The sex, ages and basic histological patterns of 78 patients with the metastatic tumors in axillary lymph nodes in the last 20 years were analyzed, and the relationship between some pathologic parameter and the primary sites of 62 patients (male 16,female 46) in metastasis of known origin(MKO) were especially analyzed. Results (1) 20.5% cases were from MUO, the ratio of MUO in male(30.43%) was much higher than that in female(14.81%) remarkably. (2)The ages of male was lower than that of female remarkably. (3) The adenocarcinoma was the predominant patterns both in female and male, the ratio in female (84.78%) was larger than female (48.78%) remarkbly. (4) The number of the primary tumor sites in female (6 locations) was more than that in male(3 locations). (5) In female, the first and the second primary location was the breast (82.66%) and the lung respectively both in left and right side, the others were the oesophagus, endometrium, cervix and skin of wrist. (6) In male, the first primary location was lungs in both sides, the others were the stomach and the oesophagus. Conclusions For the metastatic tumors of axillary lymph nodes, the primary site mainly is the breast in female; and in male, all are from the organs of thorax and abdominal cabity, mainly the lungs.