关键词: 锁骨上淋巴结, 细针, 粗针, 病理类型

Abstract: Objective To explore the clinical application value of ultrasound-guided fine needle aspiration combined with coarse needle biopsy in the diagnosis of supraclavicular lymph node lesions. Methods A total of 147 supraclavicular lymph node puncture specimens that underwent both ultrasound-guided fine needle aspiration combined with coarse needle biopsy in our department from January 2016 to May 2022 were retrospectively selected for analysis of their clinicopathological data. Results The results showed that the sampling satisfactory rate of supraclavicular lymph node was approximately 99% in 147 cases, and the overall diagnosis rate was approximately 82.3%. Two of the patients could not be diagnosed due to inadequate sampling and 24 could not be specifically staged due to immunohistochemistry. 113 cases were clearly identified as supraclavicular lymph node metastases from lung cancer and could be further differentiated between small cell carcinoma and non-small cell carcinoma. Non-small cell carcinoma can be subdivided into adenocarcinoma and squamous carcinoma. Some rare types of lung cancer such as neuroendocrine tumours, typical carcinoid tumours and lymphoepithelioma-like carcinomas were also diagnosed in the supraclavicular lymph nodes. We also identified eight specimens of extra-pulmonary origin from the gastrointestinal tract, gynaecological, urological, breast and haematological systems. Conclusion This study shows that fine needle aspiration combined with coarse needle biopsy has a high clinical value in the pathological diagnosis and staging of supraclavicular lymph node disease, and it avoids unnecessary surgical excisional biopsies to a certain extent.

Key words: supraclavicular lymph nodes, fine-needle aspiration, core-needle biopsy, pathological type