淋巴结针吸细胞病理学对淋巴结核早期诊断的研究应用_医学论文.docVIP

淋巴结针吸细胞病理学对淋巴结核早期诊断的研究应用_医学论文 淋巴结针吸细胞病理学对淋巴结核早期诊断的研究应用_医学论文 王 颖1，王永才1，赵成艳1，李海东 【摘要】 目的 探讨淋巴结针吸细胞病理学对淋巴结核早期诊断的研究，提高淋巴结核诊断准确率。方法 根据显微镜下淋巴结核不同时期的针吸细胞病理学特点及特征性结构改变，结合抗酸染色和结核抗体检测做出分型诊断。结果 在1090例结核性淋巴腺炎中，男360例，占33.0%，女730例，占67.0%，年龄1～78岁，平均28.3岁。结核初期-炎性增殖期60例，占5.5%；结核早期-淋巴结节期130例，占11.9%；结核中期-结核性结节期有590例，占54.1%结核晚期-干酪样脓样坏死期有280例，占25.7%结核恢复期-纤维素增殖期30例，占2.8%。炎性增殖反应期非特异性形态学变化，需要结合结核抗体阳性和腺苷酸脱氨酶明显增高有助于诊断，结核结节期主要可有较多类上皮样细胞及郎罕氏细胞 而干酪样脓样坏死主要见大量坏死组织及碎屑、少数残碎不全类上皮样细胞，此期主要能查到抗酸菌为特点 纤维增殖期，抽出物难取，仅见少数纤维组织、纤维细胞和黏液间质为其特征，提示结核恢复、瘢痕形成所致。结论 应用淋巴结针吸细胞病理学分型诊断，而且为淋巴结核早期诊断、早期发现、早期治疗提供重要方法。 【关键词】 淋巴结；针吸；结核；早期诊断 【Abstract】 Objective To evaluate the research of needle aspirate cytology of lymph node in the diagnosis of the typing of tuberculous lymphadenitis and the function of the typing to improve the accurate rate in diagnosis.Methods tuberculous lymphadenitis type were diagnosed according to the FNA pathological characteristics and specific construction modification under the microscope，with the aid of acid-fast stain and tuberculous antibody’s detection.Results The 1090 cases included 360 males， making up 33.0% and 730females， making up 67.0% ，with age arranged from 1to 78 years old and an average age of 28.3.The results showd that 60 cases (5.5%) were of the inflammation reaction hyperplastic stage (1) 130 cases (11.9%) lymphatic nodular stage (2) 590 cases (54.1% ) tuberculous nodular stage (3) 280 cases (25.7% ) caseous necrosis stage (4) and 30 cases (2.8% ) fibrinous hyperplastic stage (5).The inflammation reaction hyperplactic stage and lymphatic nodular stage are of nonspecific morphological changes and should be diagnosed with the help of positive tuberculin test and obvious increase of adenosine deaninase (ADA ) tuberculous nodular stage has a great number of epithelioid cells，and Langhans cells， caseous necrosis stage is characterized by a great deal of necrotic tissue and debris，a small number of fragmented epithelioid cells， and mainly by antiacid bacteria fibrinous hyperpla