加德满都三级卫生保健医院淋巴结病的细胞形态学研究

A. Khadka, S. Pudasaini, Bipin Maharjan
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摘要

淋巴结病是临床实践中最常见的问题。各种病因可引起淋巴结病。淋巴结病的细胞形态学研究是诊断许多疾病过程的窗口。抽吸细胞学检查为准确筛查患者提供了一种可靠、安全、快速、经济的方法。它可以区分肿瘤性病变和非肿瘤性病变,从而影响患者管理,防止患者接受不必要的手术。在加德满都一家三级卫生保健医院的病理科进行了为期三年(2019年6月1日至2022年5月30日)的医院描述性研究。本研究共纳入331例淋巴结病。本研究的目的是评估淋巴结病的细胞形态学表现。331例淋巴结病中,281例(84.9%)为非肿瘤性,47例(14.2%)为肿瘤性。在非肿瘤性病变中,反应性淋巴结炎113(34.1%)是最常见的诊断,其次是结节性淋巴结症、肉芽肿性淋巴结病、化脓性淋巴结痛和坏死性淋巴结结炎。肿瘤中转移癌40例(12%),淋巴瘤7例(2.1%)。在转移癌中,最常见的是鳞状细胞癌,其次是乳腺癌、腺癌和甲状腺乳头状癌。其他转移癌为肺小细胞癌和黑色素瘤。本研究表明,淋巴结细胞形态学研究是准确评估淋巴结病患者的一种方便方法。
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Cytomorphological Study of Lymphadenopathy at a Tertiary Health Care Hospital in Kathmandu
Lymphadenopathy is most commonly encountered problems in clinical practice. Various etiological factors can cause lymphadenopathy. Cytomorphological study of lymphadenopathy is a window for diagnosis of many disease processes. Aspiration cytology provides a reliable, safe, rapid and economical method of screening the patients with accuracy. It can differentiate neoplastic from non-neoplastic lesions and therefore influences patient management preventing patient from being subjected to unnecessary surgery. Hospital based descriptive study was carried out in the Department of Pathology of a tertiary health care hospital in Kathmandu over a period of three years (1st June 2019 to 30th May 2022). A total of 331 cases of lymphadenopathy were included in the study. The aim of this study was to evaluate the cytomorphological findings of lymphadenopathy. Out of 331 cases of lymphadenopathy, 281 (84.9%) of the cases were non-neoplastic and 47 (14.2%) were neoplastic. Among non neoplastic lesions, reactive lymphadenitis 113 (34.1%) was the most common diagnosis followed by tubercular lymphadenitis, granulomatous lymphadenitis, suppurative lymphadenitis and necrotizing lymphadenitis. Among neoplastic, 40 (12%) were metastatic carcinoma and 7 (2.1%) were lymphoma. Among metastatic carcinoma the most common was squamous cell carcinoma followed by breast carcinoma, adenocarcinoma, papillary carcinoma of thyroid. Other metastatic carcinoma were small cell carcinoma of lung and melanoma. This study showed that cytomorphological study of lymph node is a convenient procedure for accurate assessment of patients with lymphadenopathy.
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