Tiếp cận chẩn đoán và xử trí hạch cổ ác tính

Abstract

Background: Cervical lymph node is one of common clinical symptoms in examination of head and neck. The differential diagnosis of benign or malignant node to have properly treatment is suitable extremely important and necessary for specialist physicians. However, the diagnosis isn’t always easy, especially cervical lymph node metastates from an unknow primary tumor. Many directions which are based on medical evidence have been showed, contributing to simplify the diagnosis for the sequence and no omission as well as the treament in appropriate and effective way.
Materials and methods: The directions are synethesized from a lot of studies with high level of medical evidence (the clinical trials controlled studies, cohort studies…) and are recommended by guidelines of many prestigious associations in the world, for example NCCN (National Comprehensive Cancer Networld), UICC (Union for International Cancer Control), ASCO (American Society of Clinical Oncology), AAO-HNS (American Academy of Otolarynology-Head and Neck Surgery)… Results: The diagnosis should be need combination of clinical examination, the tools of radiology such as: ultrasound, CTScan, PET - CT, and the procedures of biopsy, for example ultrasonograph - guided fine needle aspiration, core biopsy or open surgerical biopsy. Histologically, squamous cell carcinoma is the most common type. The management is depended on histological type of cervical lymph node as well as with or without primary tumor. Surgery (neck dissection) is still the first option if no indication.