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哪些颈部肿大淋巴结需要穿刺活检 苗润琴 山西省肿瘤医院 肿大淋巴结怀疑下列几种情况时需要考虑穿刺活检:1、急慢性感染或考虑淋巴结核时,这个时候淋巴结也会表现为肿大,常常颈部触及多发的结节,虽然都是炎症,但治疗方法以及过程却相差万里,急慢性炎症只需要消炎治疗,结核则需要长期的抗结核治疗,因此淋巴结穿刺活检非常必要;2、颈部致硬的多发大小不等肿块,不能除外恶性淋巴瘤时,需做穿刺活检,取得病理诊断;3、肿瘤转移至淋巴结时,如患者有原发病,如肺癌颈部不明原因出现肿块时,为了解决肿块的性质,肿块与原发病的关系,需要做肿物的穿刺活检;4、其它需要病理明确诊断的肿大淋巴结,如结节病,与淋巴瘤都表现为淋巴结的异常肿大,从临床症状上难以区分,但治疗方法也截然不同,淋巴瘤需要做多个疗程的化疗,而结节病需要激素的规范化治疗,因此必须取得病理诊断,才能够给临床的下一步诊断和治疗提供依据。 Which enlarged lymph nodes in the neck need biopsy When the enlarged lymph nodes are suspected of the following conditions, the puncture biopsy should be considered: 1. When the acute and chronic infection or the tuberculosis of lymph nodes are considered, At this time, the lymph nodes will also show swelling, The neck often touches multiple nodules, It's all inflammation, But the treatment methods and process are far from each other, Acute and chronic inflammation only needs anti-inflammatory treatment, Tuberculosis requires long-term anti tuberculosis treatment, Therefore, lymph node biopsy is very necessary; 2. Multiple hard masses of varying sizes in the neck, When malignant lymphoma cannot be excluded, A biopsy is needed, Obtain pathological diagnosis; 3. When the tumor metastases to lymph nodes, If the patient has primary disease, If there is a tumor in the neck of lung cancer with unknown cause, To address the nature of the mass, The relationship between mass and primary disease, Biopsy of the tumor is needed; 4. Other enlarged lymph nodes that need to be diagnosed pathologically, If sarcoidosis, And lymphoma showed abnormal enlargement of lymph nodes, It is difficult to distinguish from clinical symptoms, But the treatment is very different, Lymphoma requires multiple courses of chemotherapy, And sarcoidosis needs standardized hormone treatment, Therefore, pathological diagnosis must be made, It can provide the basis for the next diagnosis and treatment.