摘要目的 探讨颈部淋巴结针吸细胞学诊断的准确率及误诊原因.方法 分析580例颈部淋巴结针吸细胞学检查结果.其中161例在原部位取活检,分析针吸细胞学与组织学诊断符合率及误诊原因.结果 580例中淋巴结反应性增生226例,特异性炎202例,恶性淋巴瘤45例,转移癌107例.161例针吸细胞学与组织学诊断符合率为94.4%.107例转移癌中96例经临床及病理检查确定了原发灶.细胞学与组织学对照结果显示,细胞学检查有9例误诊,针吸细胞学误诊主要原因是吸取组织量少,对病变了解不全面;误诊病例结合病史及临床表现均有考虑到其他疾病的可能性.结论 颈部淋巴结针吸细胞学诊断准确率较高,但对可疑病变及原发肿瘤的分型,针吸细胞学仅可给予提示件初步诊断,需经组织学活检,必要时免疫组织化学诊断分型.

abstractsObjective Study on the diagnostic accuracy of fine needle aspiration biopsy of cervical lymph nodes and to discuss the reasons of making a misdiagnosis. Methods Five hundred and eighty cases of cervical lymph node fine needle aspiration biopsy were reviewed retrospectively. Among them, histologic findings were available in 161 cases. The cytologic and histologic diagnoses were compared. Results There were altogether 226 cases of reactive lymphoid hyperplasia, 202 cases of specific inflammation, 45 cases of malignant lymphoma and 107 cases of metastatic carcinoma. The concordance rate between the cytologic and corresponding histologic diagnoses was 94.4%. The primary foci of most cases with metastatic carcinoma could be delineated by reviewing the clinical and pathologic finding. Inadequate cellularity was the main reason of making misdiagnosis and useful diagnostic clues might be obtained by coreful study of the clinical findings. Conclusions Fine needle aspiration biopsy of cervical lymph node carries a high diagnostic accuracy. It provides important clues in guiding subsequent clinical management. However, for detailed subtyping of certain disease entities such as malignant lymphoma, surgical biopsy for histologic and immunohistochemical studys are required.