无鼻咽部症状的鼻咽癌患者颈淋巴结转移49例误诊分析

目的 :探讨无鼻咽部症状的鼻咽癌患者颈淋巴结转移临床误诊原因。方法 :行细针穿刺细胞学检查淋巴结 ,纤维鼻咽镜活检病理证实鼻咽癌。结果 :鼻咽癌患者颈部淋巴结转移 4 9例 ,误诊为颈部淋巴结炎 33例 (细胞学诊断鳞状细胞癌 10例 ,腺癌 4例 ,未分化癌 16例 ,类型未定转移癌 3例 ) ;误诊为淋巴结核 13例 (细胞学诊断鳞状细胞癌 3例 ,腺癌 2例 ,未分化癌 7例 ,类型未定转移癌 1例 ;误诊为霍奇金病 3例 ,细胞学诊断未分化癌 2例 ,类型未定转移癌 1例 )。纤维鼻咽镜活检病理均为鼻咽癌。结论 :无鼻咽部症状的鼻咽癌患者颈部淋巴结肿大 ,行穿刺细胞学检查对明确诊断有指导意义

49 Cases Misdiagnosis of Nasopharyngeal Carcinoma With Cervical Lymph Nodes Metastasis Without Na-sopharyngeal Symptom

Objective To explore misdiagnostic cause of nasopharyngeal carcinoma with cervical lymph node metastasis without nasopharyngeal symptom.Methods The lymph nodes were examined by the fine needle aspiration cytology.The nasopharyngeal carcinoma was determined by pathology.Results Among 49 cases with cervical lymph nodes metastasis,there were 33 patients diagnosed falsely lymph node imflammatory(10 squamos cellcarcinoma,4 adenocarcinoma,16 non differentiated carcinoma,and 3 metastastic carcinoma diffcult to determine in cytology);there were 13 patients diagnosed falsely lymph node tuberculosis(3 squamos cellcarcinoma,2 adenocarcinoma,7 non differentiated carcinoma,and 1 metastastic carcinoma to difficult determine in cytology);there were three patients diagnosed falsely Hodgkin's disease(two non differentiated carcinoma,and two metastastic carcinoma to determine in cytology).These patients were diagnosed nasopharyngeal carcinoma by pathology.Conclusion It is very important to do the fine needle aspiration cytology for the patients with cervical lymph nodes metastasis without nasopharyngeal symptom.