经口腔超声引导穿刺检查在恶性肿瘤疗后咽后间隙淋巴结肿大和咽旁间隙肿块中的临床价值  

The role of transoralsonography guiding fine-needle aspiration biopsy in the diagnosis of retropharyngeal or parapharyngeal masses identified on the images of treated patients with malignant carcinoma

作　　者：张有望[1] 黄雅芳[2] 应红梅[1] 孔琳[1] 吴永如[1] 杜承润[1] 胡超苏[1] 

机构地区：[1]复旦大学上海医学院肿瘤学系 复旦大学附属肿瘤医院放疗科,上海200032 [2]复旦大学上海医学院肿瘤学系 复旦大学附属肿瘤医院超声诊断科,上海200032

出　　处：《中华放射肿瘤学杂志》2015年第4期427-430,共4页Chinese Journal of Radiation Oncology

摘　　要：目的：探讨经口腔超声引导穿刺细胞病理检查对恶性肿瘤疗后影像学发现咽后肿大淋巴结或咽旁间隙肿块性质的诊断价值。方法2002—2013年间55例恶性肿瘤放疗后患者经 CT、MR 检查发现44例咽后间隙肿大淋巴结、10例咽旁间隙肿块，PET.CT 检查发现咽后肿大淋巴结1例。50例放疗患者中46例鼻咽癌、3例食管癌和1例肺尖癌；4例手术治疗患者分别为甲状腺乳头癌、颊黏膜鳞癌、声带鳞癌及乙状结肠腺癌；1例术后放疗患者为鼻腔嗅神经母细胞瘤。经口腔超声检查发现咽后间隙淋巴结肿大45例和咽旁间隙肿块10例的低回声区病灶，并在超声引导监督下肿块穿刺活检。结果37例咽后间隙肿大淋巴结经穿刺细胞病理学证实为癌，检出率为82％，3例鼻咽癌放疗后咽旁间隙肿块穿刺细胞病理学证实为癌，检出率为30％。结论经口腔超声引导穿刺细胞病理学检查可作出原发恶性肿瘤疗后淋巴结转移和咽旁间隙复发的细胞病理诊断，有利于提早诊断和提供合理治疗的依据。Objective To investigate the role of transoralsonography guiding fine.needle aspiration biopsy in the diagnosis of retropharyngeal or parapharyngeal masses identified on the CT, MRI or PET.CT images of treated patients with malignant carcinoma. Methods From 2002 to 2013,this study recruited fifty.five patients with a history of cancer, of which 50 were treated with radiation treatment, including 46 nasopharyngeal carcinoma, 3 esophagus squamous cell carcinoma and1 lung apex carcinoma. There were 4 patients with a history of 1 thyroid papillary carcinoma, 1 buccal mucosa squamous cell carcinoma,1 glottis squamous cell carcinoma and 1 sigmoid colon adenocarcinoma treated with surgery. The rest one patient with nasal olfactory neuroblastoma was treated by postoperative radiation. The enlarged retropharyngeal lymph nodes in 44 cases and parapharyngeal masses in 10 cases were identified on CT or MRI imges. The enlarged retropharyngeal lymph node in the rest case was identified on PET.CT. With transoral ultrasound examination, all lesions were with hypo.intensity echo. Cystic areas were noted on occasion. Biopsy was performed in all cases. Results After cytology examination, carcinoma cells were detected in 37 retropharyngeal lymph nodes, with a detection rate of 82% （37/ 45）. In the 10 parapharyngeal masses, carcinoma cells were detected in 3 lesions, with a detection rate of 30%. Conclusions Transor alsonography guiding fine.needle aspiration biopsy can be useful in the cytopathology diagnosis of retropharyngeal or parapharyngeal masses identified on the CT, MRI or PET.CT images of treated patients with malignant carcinoma,which facilitates, early diagnosis and treatment for patients.

关 键 词：咽后间隙淋巴结 咽旁间隙肿块 经口腔超声引导穿刺 活组织检查 针吸 细胞病理学 

分 类 号：R730.4[医药卫生—肿瘤]