颈部淋巴结结核超声表现与病理对照研究  

Ultrasound Characteristics of Cervical Tuberculous Lymphadenitis Correlating with Pathology

作　　者：张更臣[1] 李俊来[1] 曹兵生[2] 黎晓林[2] 宋晶莹[3] 余美琴[1] 

机构地区：[1]解放军总医院超声科,北京市100853 [2]解放军309医院超声科 [3]解放军309医院病理科

出　　处：《中国超声医学杂志》2013年第10期879-882,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨颈部淋巴结结核超声表现及其病理基础。方法分析和总结经病理确诊的89例颈部淋巴结结核的声像图表现,对照病理分析其图像特点的病理基础。结果本组89例颈部淋巴结结核声像图表现分为3种类型:Ⅰ实质型(37例)超声显示内部回声大致均匀,与病理对照,可见多个典型结核肉芽肿结构,肉芽肿中心无或仅见微小干酪样坏死区。Ⅱ囊实混合型(34例)超声显示周边内壁不均匀增厚,中部可见不规则无回声区。与病理对照,周边为不典型的肉芽肿病变,散在的朗罕氏细胞,多伴有纤维组织增生。中央见大片融合干酪样坏死。Ⅲ钙化型(18例)超声显示内部可见斑块样或长条状强回声钙化。与病理对照,纤维组织增生、坏死或/和结核性肉芽肿。结论颈部淋巴结结核超声表现与其病理变化有密切关系,超声可清晰显示颈部淋巴结结核各种特征,直接反映其病变各个阶段的病理基础。Objective To study the correlations between ultrasound manifestations of cervical tuberculous lym phadenitis（CTBL） and its pathological findings. Methods 89 cases of CTBL were studied with conventional ukra- sound. Ultrasound-guided biopsy was done for each different regions of tuberculotic lesion and their pathologic statuses were studied. Results 89 cases of CTBL were divided into three types： I solid masses （37 cases） manifested as horn ogeneous on US. The corresponded pathologic findings were multiple tuberculous granulomas in lymph nodes,with or without minimal necrosis.Ⅱ cystic solid mixed masses （34 cases） demonstrated uneven thickening in surrounding wall and irregular echoless area in centre. Corresponded pathologically to the central large area of caseation necrosis with peripheral epithelioid granulomas reaction sporadic as well as Langhans giant cell and fibroplasia. Ⅲ calcified masses （18 cases） manifested interior plaque or stripe strong echo calcification. The corresponded pathologic findings were fibroplasia in lymph nodes,with or without granulomas. Conclusions The ultrasound manifestations of cervical tubercu lous lymphadenitis are related to its pathological status, US manifestations may reflect wlrious pathological characteris tics in the different stages of CTBL and lead to a correct diagnosis in most cases.

关 键 词：超声 结核 颈淋巴结 病理学 

分 类 号：R445.1[医药卫生—影像医学与核医学]