目的：探讨艾滋病相关浅表淋巴结结核（ASLTB）病灶超声与病理学改变及其临床意义。方法：回顾性分析经广西医科大学附属南宁市传染病医院超声介入穿刺活检病理证实的139例ASLTB患者的超声及病理等资料。结果：139例ASLTB患者，病灶超声表现呈假肾征阳性实性回声即Ⅰ型17例（12.2%），病理改变以结核肉芽肿为主；假肾征阴性实性回声即Ⅱ型89例（64%），病理改变为结核肉芽肿与干酪样坏死兼有；实液混合回声即Ⅲ型33例（23.8%），病理改变以干酪样坏死为主；合并的窦道征指向多变，钙化征极少（7/139）。超声表现为Ⅱ型和Ⅲ型患者的血CD4+ T淋巴细胞计数明显低于Ⅰ型（P＜0.001）。结论：ASLTB超声表现多样，超声表现与其病理学改变、血CD4+ T淋巴细胞计数有一定相关性，超声引导穿刺活检有助于确诊。
Abstract
Objective: To investigate the ultrasonic image feature, the pathological characteristics and the clinical significance of AIDS-related superficial lymph node tuberculosis(ASLTB) niduses. Methods: To retrospectively analyse the ultrasonic image and pathology of 139 ASLTB cases confirmed by ultrasound-guided biopsy of pathology in the Affiliated Nanning Infectious Diseases Hospital of Guangxi Medical University. Results: Among 139 cases with ASLTB, 17(12.2%) had positive solid echoes of pseudokidney sign named type Ⅰ, and the main pathological changes were tuberculous granuloma; 89(64%) had negative solid echoes of pseudokidney sign named type Ⅱ, the main pathological changes were tuberculous granuloma and caseous necrosis; 33(23.8%) had mixed echoes of solid-liquid named type Ⅲ and the main pathological changes were caseous necrosis, the sinus sign of type Ⅲ is variable and the calcification sign is rare(7/139). The CD4+ T lymphocyte counts in cases with type Ⅱ and type Ⅲ were significantly lower than that in cases with type Ⅰ(P<0.001). Conclusion: The ultrasound images of ASLTB are complex and varied, which are related to pathological changes and blood CD4+ T lymphocyte count, and the ultrasound-guided puncture biopsy is helpful for the diagnosis.
关键词
获得性免疫缺陷综合征 /
结核 /
淋巴结 /
超声检查
Key words
Acquired immunodeficiency syndrome /
Tuberculosis, lymph node /
Ultrasonography
中图分类号：
Ｒ512.91
Ｒ522
Ｒ445.1
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基金
广西南宁市科学研究与技术开发计划项目（No.20143147）。
