小儿肠系膜淋巴结炎的超声诊断

目的:探讨彩色超声在小儿肠系膜淋巴结炎的诊断价值。方法:回顾性分析山西省人民医院超声科经临床诊断的89例肠系膜淋巴结炎患儿的声像图特点。结果:89例患儿均有不同程度肠系膜淋巴结肿大,抗感染治疗后复查淋巴结明显缩小或消失。结论:彩色超声在小儿肠系膜淋巴结炎的诊断中具有重要意义,是小儿肠系膜淋巴结炎临床诊断与疗效观察的首选检查方法。     

颈部淋巴结结核的CT诊断

目的分析颈部淋巴结结核的CT表现,探讨诊断价值及鉴别诊断。方法回顾分析15例颈部淋巴结核的MSCT表现。全部病例均经病理证实。其中男2例,女13例。年龄13-66岁。结果颈部淋巴结结核好发于胸锁乳突肌周围。根据增强扫描强化方式不同可以反映病理改变的不同。结论 MSCT在颈部淋巴结结核的诊断有着重要价值,增强扫描可以反映病理改变。     

23例坏死性淋巴结炎的临床及病理分析

分析了２３例坏死性淋巴结炎病例。此病多见于年轻女性，临床主要表现为颈部淋巴结肿大伴发热，组织学改变复杂，易误诊为其他淋巴结炎和恶性淋巴瘤；淋巴结活检是诊断本病的重要手段。本病具有自限性，抗生素治疗无效     

颈部淋巴结肿大180例临床病理分析

目的：探讨颈部淋巴结肿大的病因,以指导临床诊断与治疗.方法：对2008年1月至2013年4月以颈部淋巴结肿大为首发症状并行病理活检的颈部淋巴结肿大患者180例临床病理资料进行回顾性分析.结果：180例患者中,恶性淋巴结肿大96例（53.33％）,其中主要为转移癌39例（40.62％）和非霍奇金淋巴瘤40例（41.67％）,不明原因转移癌8例（20.51％）;良性淋巴结肿大84例（46.67％）,其中主要为非特异性淋巴结炎32例（38.09％）和淋巴结结核34例（40.48％）.结论：颈部恶性淋巴结肿大以转移癌和非霍奇金淋巴瘤最为常见;良性淋巴结肿大以非特异性淋巴结炎与淋巴结结核较为常见.对不明原因颈部淋巴结肿大的病例,应及时行淋巴结活检以明确诊断.     

Tubercular lymphadenitis - diagnostic evaluation

Tuberculosis is one the commonest disease affecting peripheral lymph node and cervical tubercular lymphadenitis are frequently encountered in Otolaryngological practice. Three hundred fifty six (356) cases of Fine Needle Aspiration for Cytology (FNAC) positive tubercular lymphadenitis were studied from January 2006 to December 2008. FNAC positive but histopathologically negative cases were excluded from the study. Among 356 cases of FNAC positive cervical lymphadenopathy 300 cases (84.27%) were confirmed tuberculosis on histopathological examination. Remaining 50 cases (15.73%) were diagnosed as nontubercular lymphadenitis where nonspecific lymphadenitis was the commonest finding 34(9.55%) followed by metastatic carcinoma 7(1.97%), lymphoma 6(1.08%), Kikuchiz's disease 6(1.08%), Kala-Azar 2(0.56%) & Leukemia 1(0.28%). Most of the patients presented with only multiple lymph node swelling with other symptoms, such as fever 18(5.06%), pain (15.7%), tenderness 53(14.88%), weight loss 29(8.14%), anorexia 33(9.26%). Following observations are evident from this study: i) Disease is comparatively common between 12-35 years ii) Multiple matted/discrete lymph nodes are the earliest presentation iii) Multiple lymph node is the most consistent finding for clinical diagnosis. iv) Very few patients have constitutional symptoms v) Suppuration with or without abscess formation although confirms the diagnosis even then certainty is very essential. Though the evidence of cervical tuberculosis was thought to be decreasing in developing countries the real picture seems to be different. Random survey among the whole population was not done in any country rather hospital based laboratory research was made.     

Morphometric evaluation of nucleolar organiser regions in reactive and neoplastic lymph node lesions

Argyrophilic nucleolar organiser regions (AgNORs) have widely been used for making diagnostic as well as prognostic statements in neoplastic lesions. The present study was aimed at the quantitative and morphometric analysis of AgNORs in various lesions of lymph node. Thirty cases consisting 10 cases each of reactive lymphadenitis, non-Hodgkin's lymphoma (NHL) and metastatic deposits from carcinoma breast were included in the present study. Out of the ten cases of NHL, there were four cases of low grade and six cases of high grade lymphoma. The quantification of AgNOR dots and their morphometric evaluation were done using a specific programme of an automatic image analyser. The results revealed that mean AgNOR count was maximum in metastatic lymph nodes (5.37 +/- 0.35) when compared with NHL (high grade 5.12 +/- 0.27; low grade 4.61 +/- 0.13) and reactive lymphadenitis (2.45 +/- 0.49). The mean area of single AgNOR dot in metastatic lymph node, high grade lymphoma, low grade lymphoma and reactive lymphadenitis were 123.3 +/- 26.1, 95.3 +/- 12.2, 99.6 +/- 6.53 and 87.4 +/- 8.45 respectively. Similarly, the mean of total AgNOR area in metastatic lymph nodes was highest (668.4 +/- 169.9) followed by NHL (high grade 496.35 +/- 53.2; low grade 459.25 +/- 37.35) and reactive lymph node (215.0 +/- 37). However, the ratio of single AgNOR area to nuclear area was maximum in reactive lymphadenitis (0.132 +/- 0.001) followed by low grade NHL (0.083 +/- 0.0096), high grade NHL (0.073 +/- 0.0098) and metastatic lymph nodes (0.064 +/- 0.001). The ratio of total AgNOR area to nuclear area was also minimum in reactive lymph node when compared with other neoplastic lesions. Statistically, the p-value revealed a highly significant difference among all these lesions. Thus, it can be concluded from the present study that AgNOR count and other morphometric parameters are significantly altered in different lesions of lymph node which may aid in differentiation of problematic cases.     

小儿腹部肿大淋巴结分析

目的比较健康儿童与肠系膜淋巴结炎患儿腹腔肿大淋巴结的差异情况。方法以淋巴结短径>0.5 cm作为淋巴结肿大的诊断标准,对健康儿童137例及148例临床诊断为肠系膜淋巴结炎患儿腹腔肿大淋巴结行回顾性研究,并进行统计学分析。结果淋巴结多位于右下腹和脐周(46.3%位于右下腹,19.2%位于脐周,13.6%位于左下腹)。3个以上成簇的淋巴结健康儿童53%(72/137),淋巴结炎患儿47%(69/148),无差异(P=0.3771)。两组间肿大的淋巴结在各个年龄段及性别间没有统计学差异,长径及长径/短径均没有统计学差异,仅两组间短径有统计学差异。结论很多健康儿童存在腹腔肿大的成簇的淋巴结,所以不能主观认为这些淋巴结的存在就是异常现象。6岁儿童腹腔肿大淋巴结出现达到高峰,然后随着年龄的增长逐渐减少。短径超过0.8 cm的腹腔淋巴结也许能够直接提示肠系膜淋巴结炎的诊断。     

组织细胞坏死性淋巴结炎35例临床病理及免疫表型分析

目的探讨组织细胞坏死性淋巴结炎的临床和病理学特点。方法回顾性分析35例组织细胞坏死性淋巴结炎的临床资料。结果 35例患者主要表现为单发或多发淋巴结肿大,并有持续性发热,淋巴结活检可见不同程度的凝固性坏死伴多种形态的组织细胞、淋巴细胞浸润,免疫组化染色显示组织细胞及T细胞较多,很少见到B细胞。结论组织细胞坏死性淋巴结炎临床表现无特异性,显微镜下淋巴结结构破坏,常见凝固性坏死,细胞异型性较大,容易误诊为淋巴瘤、结核,必须认真阅片,结合病史,避免误诊。     

高频超声引导下粗针穿刺活检诊断颈部及锁骨上窝淋巴结病变的应用价值

目的 探讨高频超声引导下粗针穿刺活检(CNB)诊断颈部及锁骨上窝淋巴结病变的应用价值。方法 选取2020年2月—2021年8月青海省人民医院收治的145例颈部及锁骨上窝淋巴结病变患者(145枚淋巴结)作为研究对象。统计临床淋巴结病变诊断结果。对比不同颈部及锁骨上窝淋巴结病变患者病理诊断结果。对比高频超声引导下CNB与病理诊断结果。并以病理诊断结果作为金标准,分析高频超声引导CNB对颈部及锁骨上窝淋巴结病变的诊断效能。结果 ≥45岁患者淋巴结恶性率高于<45岁患者(P <0.05)。不同性别、淋巴结纵横比患者淋巴结恶性率比较,差异无统计学意义(P>0.05)。高频超声引导下CNB诊断结果为恶性病变100例(肿瘤淋巴结转移71例,淋巴瘤24例,淋巴结反应性增生1例,淋巴结结核4例),良性病变45例(肿瘤淋巴结转移1例,淋巴瘤1例,淋巴结反应性增生32例,淋巴结结核11例),病理诊断结果为恶性病变97例(肿瘤淋巴结转移72例,淋巴瘤25例),良性病变48例(淋巴结反应性增生33例,淋巴结结核15例)。高频超声引导下CNB对颈部及锁骨上窝淋巴结病变诊断的敏感性、特异性和准确率...     

亚急性坏死性淋巴结炎30例临床分析

目的 探讨亚急性坏死性淋巴结炎（subacute necrotizing lymphadenitis,SNL）的病因及临床特征，分析相关实验室检查项目特点，提高对SNL的认识及与其他疾病的鉴别。方法 结合文献资料回顾分析30例临床病例。结果 临床特征表现发热、淋巴结肿大、白细胞减少；抗EB病毒抗体阳性率高；淋巴结活检确诊。结论 对于临床年轻患者不明原因发热伴淋巴结肿大疼痛者，可检查白细胞及抗EBV抗体，进而行淋巴结活检确诊，病程呈自限性，或结合糖皮质激素治疗。     

粗针穿刺确诊马尔尼菲篮状菌感染性淋巴结炎的临床病理分析

目的 分析马尔尼菲篮状菌(TM)感染性淋巴结炎的临床病理特点。方法 回顾性分析15例TM感染性淋巴结炎的临床资料、病理形态特点、病原体检查、治疗情况等。结果 15例TM感染性淋巴结炎中,男14例,女1例,年龄26~67岁,平均(49.1±11.87)岁,包括13例艾滋病和2例糖尿病患者,伴有颈部、锁骨上、腋窝、腹股沟等部位浅表淋巴结肿大。粗针穿刺的条索状淋巴结组织,其结构全部或部分被炎性病变所取代,8例显微镜下形态以吞噬病原体的组织细胞弥漫性浸润为主;5例以广泛凝固性坏死为主伴散在少量病原体及核碎屑;2例以成纤维细胞小结节状增生,形成肉芽肿结构的改变为主,多核巨细胞少、散在分布。病原体大小、形态较一致,呈圆形、椭圆形或腊肠状,团聚成簇,如桑葚样,淀粉酶消化后过碘酸希夫及六胺银染色可见包含横隔的菌体结构。15例患者血液、肺泡灌洗液、痰液或者淋巴结抽出液真菌培养均查见TM生长。临床及时抗真菌治疗,15例患者病情好转后出院。结论 TM感染性淋巴结炎往往是全身侵袭性TM病晚期阶段的突出表现之一,容易被临床误诊,通过淋巴结粗针穿刺活检及早明确诊断,以免延误治疗,从而提高治愈率。     

肠系膜淋巴结炎患儿92例高频超声表现及分析

目的：比较分析不同年龄组肠系膜淋巴结炎患儿和正常儿童淋巴结的高频超声表现。方法：应用彩色多普勒超声对92例临床诊断肠系膜淋巴结炎的患儿和50例健康对照组的腹部淋巴结进行检测,测量4个较大腹腔淋巴结,对结果进行统计分析。观察腹腔淋巴结的部位、数目、大小（纵×横径）、纵横径比值、皮质及淋巴结门回声特征、淋巴门位置及是否融合。结果：正常儿童腹腔淋巴结横径随年龄增大而缩小。0～5岁和5～10岁组患儿较正常对照组淋巴结均显著增大。以腹腔淋巴结2个或2个以上最大横径〉0.4cm为阳性诊断指标,对0～5岁组患儿诊断的敏感性为100%,特异性为84%;对5～10岁组患儿诊断的敏感性为100%,特异性为100%,为最佳选择。结论：高频超声的检查和分析能协助临床了解儿童肠系膜淋巴结的正常表现和炎症改变。     

Evaluation of fine needle aspiration cytology (FNAC) of lymph node in Mymensingh

Fine needle aspiration cytology (FNAC) is widely accepted as the accurate, sensitive, specific and cost-effective procedure in the diagnosis of lymphadenopathy. The purpose of the study was to evaluate the results of FNAC of lymph nodes in our institutions comparing with results of histopathology. We performed 117 FNAC of lymph node in a period between November 2001 to April 2002, of which, histological results were available in 81 (69.23%). Cervical lymph nodes were 102 (87.18%) and axillary lymph nodes were 15 (12.82%). Male to female ratio of the patients was 1:0.65. Patients' age ranged from 3-80 years with a median age of 23 years. FNAC diagnosis was found to be as follows: granulomatous inflammation 46 (40.35%), reactive hyperplasia 31 (27.19%), metastatic carcinoma 20 (17.54%), Non-Hodgkin's lymphoma 6(5.26%), tubercular lymphadenitis 4(3.51%), acute non-specific lymphadenitis 3(2.63%), Hodgkin's lymphoma 3(2.63%) and chronic non-specific lymphadenitis 1(0.88%). Out of 81 cases of FNAC 71(87.65%) were consisted with histopathological diagnosis of granulomatous lymphadenitis. In the malignancy of lymph node sensitivity and specificity of FNAC were 82.76% and 97.92%, respectively. So, the investigators reasonably conclude that before resort to surgical intervention FNAC may be a helpful procedure in the diagnosis of both neoplastic and non-neoplastic lesion of lymph nodes.     

高频彩超诊断小儿肠系膜淋巴结炎的临床价值

目的探讨使用高频彩超经腹壁诊断小儿肠系膜淋巴结炎的临床价值。方法应用高频彩超对临床疑似肠系膜淋巴结炎患儿58例进行检查,常规检查肝,胆,胰,脾,肾,阑尾后,加压探头重点扫查右下腹,注意观察淋巴结的大小,数量,形态及其内部及周边的血流情况,并于抗炎治疗7天和14天后复查。结果49例患儿在右下腹探及肿大的淋巴结回声,并具有较典型的声像图特征,抗炎治疗后复查淋巴结有明显减少和缩小,其内的血供也明显减少。2例在右下腹探及肿大的阑尾回声,并被术后病理所证实,7例超声检查无异常,经胃肠道解痉治疗后,症状缓解。结论应用高频彩超能为临床诊断肠系膜淋巴结炎提供可靠依据。     

高频超声在小儿肠系膜淋巴结炎诊断中的应用

目的：探讨小儿肠系膜淋巴结炎的超声表现,研究高频超声在诊断小儿肠系膜淋巴结炎中的应用。方法：对150例经临床确诊的小儿肠系膜淋巴结炎患儿的肠系膜淋巴结超声表现进行观察。结果：治疗前后炎症肠系膜淋巴结的位置分布、大小、彩色血流信号丰富程度都有其特征性变化。结论：高频超声可以通过观察小儿肠系膜淋巴结的位置分布、大小、彩色血流信号的变化作出诊断,给临床提供很大的帮助。     

高频超声对小儿肠系膜淋巴结炎的诊断价值

目的:探讨小儿肠系膜淋巴结炎的超声表现及诊断价值。方法:对150例反复腹痛,部分伴呕吐、发热、腹泻,经儿科医师诊断为肠系膜淋巴炎的患儿行高频超声检查。详细记录淋巴结回声以及出现部位、数目、大小,并用彩色多普勒观察淋巴结内部血流状况。结果:150例患儿腹腔内均可探及3枚以上淋巴回声,呈多个或簇状分布,纵径:1.0~2.7、横径:0.5~1.3,纵横比≥2.0。CDFI:肿大淋巴结内血流信号分布呈淋巴门型或无血流型,为低速低阻型,RI:<0.7,经对症及抗炎治疗后复查,肿大淋巴结较前不同程度缩小或消失。结论:高频超声作为一种经济、无创、可重复的检查方法是小儿肠系膜淋巴结炎首选的诊断方法。     

颈部淋巴结结核的彩色多普勒超声表现

目的 :分析颈部淋巴结结核 (CTBL)的彩色多普勒超声特点。方法 :回顾分析 10 5例经手术证实的CTBL 的病例资料 ,对其彩色多普勒超声表现进行分析、讨论。结果 :CTBL 好发于颈中及颈上组 (占 6 3.30 % )。所有病例均为多个淋巴结同时受累 ,87.6 2 %的病例有融合。病变中最大淋巴结二维声像图表现为匀质型 (2 .5 4 % )、粗大光点型 (11.0 2 % )、网状结构型 (12 .71% )及混杂型 (73.73% )。彩色多普勒能量图 (CDPI)表现为门部血流型 (2 4 .5 8% )、周边血流型 (2 7.97% )、混合血流型 (41.5 2 % )及无血流型 (5 .93% )。结论 :彩色多普勒超声是能清晰的显示CTBL 病变的数目、部位、形态特征 ,其超声表现较具特征性 ,正确认识其超声表现能提高本病的准确性。     

小儿急性肠系膜淋巴结炎的高频超声诊断

目的探讨高频超声对小儿急性肠系膜淋巴结炎的诊断价值。方法对年龄在2～14岁的480例小儿肠系膜淋巴结炎患者的超声声像图特征进行回顾性分析,以评价高频超声对其诊断价值。结果小儿肠系膜淋巴结炎均有典型的声像图特征,其超声诊断准确441例,诊断准确率为91.9%;漏诊24例,漏诊率为5.00%;误诊15例,误诊率为3.1%。结论高频超声诊断对小儿肠系膜淋巴结炎的诊断有较高的临床应用价值,可作为这类疑似病例的首选检查方法。     

小儿肠系膜淋巴结炎472例诊治分析

目的:探讨小儿肠系膜淋巴结炎的诊断与治疗经验,并分析其相关问题。方法:对472例诊断为肠系膜淋巴结炎患儿进行总结、分析,探讨其发病机制、诊断标准与治疗方案。结果:本组472例患儿均以急性腹痛或反复腹痛就诊,有上呼吸道症状者占74.58%,伴有恶心呕吐者占45.55%,27例右下腹可摸到肿大的淋巴结。超声检查472例均可探及多个大小不等的低回声结节。所有病例均给予抗炎,抗病毒治疗,5～10d症状消失。随访425例,随访6d至6月,腹部B超复查肠系膜淋巴结均明显缩小,纵横径比值(L/S)小于2。结论:小儿肠系膜淋巴结炎缺乏特异性临床表现,高频彩超是首选检查方法。抗炎、抗病毒治疗有效。     

64排螺旋CT对纵隔淋巴结结核和纵隔淋巴瘤的鉴别价值

目的探讨64排螺旋CT在纵隔淋巴结结核与纵隔淋巴瘤中的鉴别价值。方法20例纵隔淋巴结结核和15例纵隔淋巴瘤患者均行全肺容积扫描,所有患者均强化分析病变区淋巴结特征及CT表现。结果纵隔淋巴结结核好发于10区、密度多不均匀、钙化多见、淋巴结融合少见、环状或不均匀强化、胸部原发灶等;纵隔淋巴瘤多好发于2R和3区,密度较均匀,钙化少见,淋巴结融合多见,多数普遍均匀强化,常见结外器官受累等。结论64排螺旋CT在纵隔淋巴结结核和纵隔淋巴瘤的细节显示上有明显优势。