CAJ | 학술논문

目的：探讨超声引导下颈部淋巴结病变徒手穿刺活检的应用价值与关键技术。方法：2011年3月—2013年3月对42例不明原因颈部淋巴结增大患者在超声引导下应用18 G或16 G组织切割针经皮徒手技术活检。穿刺靶淋巴结大小为1.0 cm×0.6 cm～8.6 cm×5.0 cm，每例穿刺2~5针。所取组织条能满足病理学定性诊断要求视为取材成功。结果：39例(92.9%)所取组织量能满足病理定性诊断要求。穿刺组织病理学结果：淋巴结恶性病变12例(28.6%，其中转移性癌7例、恶性淋巴瘤5例)；良性病变26例(61.9%，其中淋巴结结核14例、反应性增生5例、慢性肉芽肿性炎4例、组织坏死性淋巴结炎3例)；性质不确定1例(2.4%)。结论：超声引导下颈部淋巴结徒手活检技术具有实时监视、精准、灵活、微创等优点，在颈部淋巴结增大的定性诊断中具有很大的应用价值。
목적：탐토초성인도하경부림파결병변도수천자활검적응용개치여관건기술。방법：2011년3월—2013년3월대42례불명원인경부림파결증대환자재초성인도하응용18 G혹16 G조직절할침경피도수기술활검。천자파림파결대소위1.0 cm×0.6 cm～8.6 cm×5.0 cm，매례천자2~5침。소취조직조능만족병이학정성진단요구시위취재성공。결과：39례(92.9%)소취조직량능만족병리정성진단요구。천자조직병이학결과：림파결악성병변12례(28.6%，기중전이성암7례、악성림파류5례)；량성병변26례(61.9%，기중림파결결핵14례、반응성증생5례、만성육아종성염4례、조직배사성림파결염3례)；성질불학정1례(2.4%)。결론：초성인도하경부림파결도수활검기술구유실시감시、정준、령활、미창등우점，재경부림파결증대적정성진단중구유흔대적응용개치。
Objective:To investigate the application value and the key technique of ultrasound-guided percutaneous biopsy of neck lymphadenopathy by freehand. Methods:Forty-two patients with neck lymphadenopathy of unknown cause from March 2011 to March 2013 underwent ultrasound-guided percutaneous biopsy using 18 G or 16 G tissue biopsy needle by freehand, The size of 1ymph nodes was 1.0 cm×0.6 cm-8.6 cm×5.0 cm. Each patient was punctured 2 to 5 times, A biopsy was considered technically successful if a targeted tissue was obtained and it could meet the requirement of qualitatively pathologic diagnosis. Results: The rate of technically successful biopsy which could meet the requirement of qualitatively pathologic diagnosis was 92.9%, The pathological results showed that lymph nodes in 12 patients (28.6%) were malignant, including metastatic carcinoma in 7 patients and malignant lymphoma in 5 patients, while lymph nodes in 26 patients (61.9%) were benign, including tuberculous lymphadenitis in 14 patients, reactive hyperplasia in 5 patients, chronic granulomatous inlfammation in 4 patients and histiocytic necrotizingly lymphadenitis in 3 patients. There was one case with uncertainty (2.4%). Conclusion:Ultrasound-guided percutaneous biopsy by freehand is real-time, accurate, lfexible and minimally invasive. It has high value in diagnosis of cervical lymphadenopathy.