由于原因不明,疑似恶性肿瘤或淋巴结肿大的患者需要进行淋巴结活检。淋巴结活检可作为细针穿刺活检,核心活检,或切除淋巴结活检。特别是,除非分为亚组,否则恶性淋巴瘤的诊断被认为不足以进行肿瘤治疗。可以进行核心活检和切除活检以诊断淋巴瘤并将其分类为亚组。在某些情况下,核心活检对于淋巴瘤的诊断也可能受到限制。因此,患者被转至外科部门进行切除淋巴结活检。本文旨在分析我们部门为诊断目的进行的切除淋巴结活检的结果。回顾性分析了2008年1月至2020年1月在萨卡里亚大学医学院培训和研究医院接受诊断性切除淋巴结活检的73例患者的数据。根据年龄对患者进行评估,性别,活检部位,病理诊断,切除淋巴结的数目和直径。年龄小于18岁的患者,那些前哨淋巴结活检的,对任何已知恶性肿瘤进行的淋巴结清扫术被排除在研究之外.采用SPSS统计软件进行统计学数据分析。其中女性37例(50.7%),男性36例(49.3%),平均年龄52.07(18-90)岁。32例患者行腋窝淋巴结活检,腹股沟淋巴结活检29例,3例患者颈淋巴结活检,6例腹内淋巴结活检,纵隔淋巴结活检1例,锁骨上淋巴结活检2例。所有淋巴结活检均作为切除活检进行。在36例(49.3%)患者中检测到恶性肿瘤。在37例(50.3%)患者中,发现淋巴结病的原因是良性病变。当检查恶性疾病的原因时,观察到23例(31.5%)患者被诊断为淋巴瘤.5例确诊为淋巴瘤的患者中检出霍奇金淋巴瘤,在18例患者中发现了非霍奇金淋巴瘤。在13例(17.8%)患者中观察到转移性淋巴结病。在良性淋巴结病的原因中发现了反应性淋巴增生(26%)和淋巴结炎(20.5%)。切除的淋巴结数量在1至4个之间,直径在9至75mm之间(平均:29.53±15.56mm)。良性和恶性患者按性别差异无统计学意义。年龄,淋巴结直径,切除的淋巴结数量,和切除淋巴结活检部位。对于诊断性淋巴结活检,应主要进行细针穿刺活检和核心活检。如果在诊断中怀疑淋巴瘤,细针穿刺活检是不必要的。在这种情况下,人们认为首先进行核心活检更为合适。如果核心活检不足以诊断,手术活检更合适,以免延误诊断和治疗。切除活检是一种可以安全进行的方法,不会在可触及的周围淋巴结病中引起严重的发病率。虽然它不会导致严重的发病率,因为它是一个侵入性的过程,应在选定的患者组中进行切除活检。
Lymph node biopsy is indicated in patients with suspected malignancy or lymphadenopathy due to unclarified reasons. Lymph node biopsy can be performed as fine needle aspiration biopsy, core biopsy, or excisional lymph node biopsy. In particular, the diagnosis of malignant lymphoma is considered insufficient for oncological treatment unless classified into subgroups. Core biopsy and excisional biopsy can be performed to diagnose lymphoma and classify it into subgroups. Core biopsy may also be limited in some cases for the diagnosis of lymphoma. Therefore, patients are referred to surgical departments for excisional lymph node biopsy. It was aimed herein to analyze the results of excisional lymph node biopsies performed for diagnostic purposes in our department. Data on 73 patients having undergone diagnostic excisional lymph node biopsy at Sakarya University Medical Faculty Training and Research Hospital between January 2008 and January 2020 were retrospectively analyzed. Patients were evaluated in terms of age, gender, biopsy site, pathological diagnosis, number and diameter of lymph nodes excised. Patients younger than 18 years of age, those with sentinel lymph node biopsies, and lymph node dissections performed for any known malignancy were excluded from the study. Statistical data analysis was done using SPSS statistical software. There were 37 (50.7%) female and 36 (49.3%) male patients, mean age 52.07 (18-90) years. Axillary lymph node biopsy was performed in 32 patients, inguinal lymph node biopsy in 29 patients, cervical lymph node biopsy in 3 patients, intra-abdominal lymph node biopsy in 6 patients, mediastinal lymph node biopsy in 1 patient, and supraclavicular lymph node biopsy in 2 patients. All of the lymph node biopsies were performed as excisional biopsy. Malignancy was detected in 36 (49.3%) patients. In 37 (50.3%) patients, the causes of lymphadenopathy were found to be benign pathologies. When the causes of malignant disease were examined, it was observed that 23 (31.5%) patients were diagnosed with lymphoma. Hodgkin lymphoma was detected in 5 patients diagnosed with lymphoma, and non-Hodgkin lymphoma was found in 18 patients. Metastatic lymphadenopathy was observed in 13 (17.8%) patients. Reactive lymphoid hyperplasia (26%) and lymphadenitis (20.5%) were found among the causes of benign lymphadenopathy. The number of excised lymph nodes was between 1 and 4, and their diameter was between 9 and 75 mm (mean: 29.53±15.56 mm). There was no statistically significant difference between benign and malignant patients according to gender, age, lymph node diameter, number of lymph nodes excised, and excisional lymph node biopsy site. For diagnostic lymph node biopsy, fine-needle aspiration biopsy and core biopsy should be performed primarily. If lymphoma is suspected in the diagnosis, fine-needle aspiration biopsy is not necessary. In this case, it is believed that it is more appropriate to perform core biopsy first. If the core biopsy is insufficient for diagnosis, it is more appropriate to perform surgical biopsy in order to cause no delay in diagnosis and treatment. Excisional biopsy is a method that can be safely performed and does not cause severe morbidity in palpable peripheral lymphadenopathies. Although it does not cause severe morbidity because it is an invasive procedure, excisional biopsy should be performed in a selected patient group.