頸部リンパ節腫脹の臨床病理学的検討

結核性リンパ節炎鑑別な中心に

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Two hundred cases over a 8-year period who had surgically cervical lymphnode biopsies werestudied for the aim of clinicopathological investigations of cervical lymphadenopathy. Observingby the age group, the youngest was 10 and the oldest was 86 years of age, and the greatest number ofcases were in the age group 20 to 40 years. Patients who showed also the intrapulmonary lesions were140 (70%). Of 200 biopsied cases, 59 (29.5%) were diagnosed as metastatic changes of bronchogeniccarcinoma, 32 (16%) as sarcoidosis, 20 (10%) as tuberculous lymphadenitis, 9 (4.5%) as malignantlymphoma, 7 (3.5%) as necrotizing lymphadenitis and 52 (26%) as non-specific lymphadenitis. Piringer's lymphadenitis (toxoplasmic lymphnode infection) was seen in one case.
Most of the patients with necrotizing lymphadenitis were female in the age from 20 to 40. Common symptoms were pain or tenderness at the region of lymphnode swelling which were not seen inthe patients with non-specific lymphadenitis. Before the biopsy four patients were misdiagnosed astuberculous lumphadenitis, two of them were treated with anti-tuberculous drugs and one with steroid.
Of 20 patients with cervical tuberculous lymphadenitis, 11 were female and the majority werein the age groups 20 to 39. About half of them showed no intra-pulmonary lesions and congromeratednode formation. For the differential diagnosis of lymphadenopathy, the lymphnode biopsy is necessaryespecially in the early phase of lymphnode swelling which was suspicious of tuberculous.