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目的 :加深对以颈上深淋巴结肿大为首发表现的鼻咽粘膜下型癌的认识。方法 :报告 4例本病患者的临床资料。结果 :4例直至发现颈部淋巴结肿大 3～ 6个月后 ,才得以确诊为鼻咽粘膜下型癌 ;均行放疗加化疗 ,3例在 1年内死亡 ,1例尚生存。结论 :对颈上深部淋巴结肿大 ,首先应考虑为鼻咽粘膜下型癌的转移癌。即使细胞学、VCA- Ig A、CT、MRI、鼻咽部等检查均为阴性 ,有的甚至已确诊为淋巴结核瘤 ,但仍不能排除鼻咽粘膜下型癌存在的可能。
OBJECTIVE: To deepen the understanding of nasopharyngeal submucosal carcinoma, which is the first manifestation of deep cervical lymph nodes. Methods: The clinical data of 4 patients with this disease were reported. Results: Four cases of cervical lymphadenopathy were found to be submucosal carcinoma of the nasopharynx only 3 to 6 months after their enlargement. Three patients died within one year and one case survived. Conclusion: The deep cervical lymph nodes, should first be considered as subepidermal nasopharyngeal carcinoma metastases. Even cytology, VCA-Ig A, CT, MRI, nasopharyngeal and other tests were negative, and some have even been diagnosed as lymph node tuberculosis, but still can not rule out the possibility of sub-type nasopharyngeal carcinoma.