淋巴结针吸细胞病理学对淋巴结核早期诊断的研究应用  

The research of the diagnosis of tubereulotu lymphadenitis typing basedon needle aspirate cytology of lymphnode

作　　者：王颖[1] 王永才[1] 赵成艳[1] 李海东 

机构地区：[1]大连医科大学附属二院细胞室 [2]赤峰市中心医院检验科

出　　处：《医药世界》2006年第7期68-70,共3页Medicine World

摘　　要：目的探讨淋巴结针吸细胞病理学对淋巴结核早期诊断的研究,提高淋巴结核诊断准确率。方法根据显微镜下淋巴结核不同时期的针吸细胞病理学特点及特征性结构改变,结合抗酸染色和结核抗体检测做出分型诊断。结果在1090例结核性淋巴腺炎中,男360例,占33．0％,女730例,占67．0％,年龄1-78岁,平均28．3岁。结核初期-炎性增殖期60例占5．5％;结核早期-淋巴结节期130例占11．9％;结核中期-结核性结节期有590例,占54．1％;结核晚期-干酪样脓样坏死期有280例占25．7％;结核恢复期-纤维素增殖期30例占2．8％。炎性增殖反应期非特异性形态学变化,需要结合结核抗体阳性和腺苷脱氨酶明显增高有助于诊断,结核结节期主要可有较多类上皮样细胞及郎罕氏细胞;而干酪样脓样坏死主要见大量坏死组织及碎屑、少数残碎不全类上皮样细胞,此期主要能查到抗酸菌为特点;纤维增殖期,抽出物难取,仅见少数纤维组织、纤维细胞和粘液间质为其特征,提示结核恢复、疤痕形成所致。结论应用淋巴结针吸细胞病理学分型诊断,而且为淋巴结核早期诊断、早期发现、早期治疗提供重要方法。Objective To evaluate the research of needle aspirate cytology of lymphnode m the diagnosis of the typing of tuberculotu lymphadenitis and the function of the typing to improve the accurate rate in diagnosy .Method tuberculotu lymphademtis type were diagnosed according to the FNA pathological characteristics and specific construction modification under the microscope,with the aid of acid-fast stain and tuberculotu antibody; s detection .Result The 1090 cases in cinded 360 males making up 33.0% ,and 730females, making up 67.0% , with age arranged from lto 78 years old and an average age of 28.3.The results showd that 60 cases （5.5%） were of the inflammation reaction hyperplastic stage （1） ;130 cases （11.9%） .Lamphaticnodular stage （2） , 590 cases （54.1%） tuberculous nodular stage （3） , 280 cases （25.7%）.Caseous necrosis stage （4） , and 30 cases （2.8%） fibrinous hyperplastic stage （fi）.The inflammation reaction hyperplactic stage and lymphatic nodular stage are of nonspecffic morphological changes and should be diagnosed with the help of positive tuberculin test and obvious increase of Adenosine Deaninase （ADA） ; tuberculous nodular stage has a great number of epithelioid cells, and Langhans cells, caseous necrosis stage is charteriged by a great deal of necrotic tissue and debris, a small number of fragmented epithelioid cells, and marly by antiacid bacteria fibrinous hyperplastic stage is featured by a few fibrous tissue, cells and mucous oweing to hardness to get puncture, which neans tubercalous restoration, and scar formation. Conclusion The application of fine needle aspirate cytoiology sapplies an important nethod of early diagnosis findings and trealment.

关 键 词：淋巴结 针吸 结核 早期诊断 

分 类 号：R977.5[医药卫生—药品]