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作者收治原发灶隐匿的颈部淋巴结转移癌110例,年龄40～82岁。初诊时将颈淋巴结肿大误诊为淋巴结炎,用抗生素和物理疗法无效,甚至淋巴结进一步增大,经穿刺活检或淋巴结切除进行病理形态学检查,诊断淋巴结转移癌,其中鳞状细胞癌104例(有细胞角化99例,无角化5例),低分化癌4例,腺癌2例。 经X线检查和纤维内镜检查,查出原发灶(T_1)29例,占24％。原发灶位于鼻咽部5例,口咽部7例,喉前庭7例,舌和口底5例,乳腺3例,食管颈段1例,胃1例。
The authors treated 110 cases of cervical lymph node metastases concealed by the primary tumor and were 40 to 82 years old. At the time of the initial diagnosis, cervical lymph node enlargement was misdiagnosed as lymphadenitis. Antibiotics and physiotherapy were ineffective. Even lymph nodes increased. Pathological examinations were performed by needle biopsy or lymph node dissection to diagnose lymph node metastases, including 104 cases of squamous cell carcinoma ( There were 99 cases of cytokeratinization, 5 cases of no keratinization, 4 cases of poorly differentiated carcinoma, and 2 cases of adenocarcinoma. After X-ray examination and fiber endoscopy, 29 primary lesions (T_1) were detected, accounting for 24%. The primary lesions were located in the nasopharynx in 5 cases, in the oropharynx in 7 cases, in the larynx in 7 cases, in the tongue and in the mouth in 5 cases, in the mammary gland in 3 cases, in the esophagus in the neck in 1 case, and in the stomach in 1 case.