颈淋巴结结核临床分析

目的探讨颈淋巴结结核的临床特点、诊断及治疗方法。方法回顾性分析2004年10月～2011年5月我院收治的83例颈淋巴结结核患者的临床资料。结果 83例颈淋巴结结核患者,女性多见;肿块位于颈侧中上部30例(36.1%),锁骨上窝32例(38.6%);合并肺结核的12例(14.5%);31例行颈部CT扫描,21例增强扫描表现为肿物环形强化;11例行淋巴结针吸活检,8例确诊,其余3例经淋巴结活检确诊;3例抗结核治疗无效。结论颈淋巴结结核以颈侧部和锁骨上窝肿块为主要表现,部分合并肺结核;颈部增强CT扫描有重要的诊断价值;针吸活检不能确诊的应尽早手术活检;多数患者只需行抗结核治疗,无效者需行手术治疗。

Clinical analysis of cervical tuberculous lymphadenitis

OBJECTIVE To explore the clinical characteristics, diagnosis and treatment of cervical tuberculous lymphadenitis. METHODS The clinical data of 83 cases with cervical tuberculous lymphadenitis from October 2004 to May 2011 were analyzed. RESULTS In these 83 cases of cervical tuberculous lymphadenitis, 24（28.9%）patients aged from 31 to 40 years, 27 were male and 56 were female. The cervical masses located in the middle and upper part of the lateral neck in 30 cases（36.1%）, and located in supraclavicular fossae in 32 cases（38.6%）. Twelve cases（14.5%）complicated by pulmonary tuberculosis. Thirty one patients have been examined by computer tomography（CT）, enhanced scanning showed wall enhancement of the masses in 21 cases. Lymph node needle aspiration biopsy was carried out in 11 cases, and 8 cases were proved, the remaining 3 cases were proved by lymph node biopsy. Three patients were failed to anti-tuberculosis therapy. CONCLUSION Cervical tuberculous lymphadenitis presents most commonly in the lateral neck and supraclavicular fossa. Some patients complicated by pulmonary tuberculosis. Neck enhanced CT scanning has important diagnostic value. It should be as soon as possible to do biopsy if patients were not diagnosed by fine needle aspiration biopsy. Most patients were treated with anti-tubercular therapy alone, and others required surgical intervention followed by anti-tubercular therapy.