Author/Editor		Fischinger, Janez
Title		Otekline na vratu
Translated title		Neck masses
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 40, št. 7-8
Publication year		2001
Volume		str. 248-53
Language		slo
Abstract		A short review of the most common diseases, which appear as neck masses and diagnostic steps for their management are discussed. In children and young adults neck masses are usual consequences of inflammatory adenopathy. Such patients are treated by a general practitioner family doctor. Patients with enlarged cervical lymph nodes and with a lack of response to antibiotic treatment exceeding 3 to 4 weeks should be referred to an ENT surgeon. Endoscopic, fiberoptic examination often reveals the cause of the neck mass. Major part of the abscesses, congenital and developmental anomalies, benign and malignant tumours of the cervicofacial region of the head and neck can be treated surgically. If the clinical evaluation of the neck mass does not lead to a definite diagnosis, a fine needle biopsy and examination by specialist for infectious diseases should be considered. When considering a metastasis, there is a need for the localization of primary tumour. If a systemic disease is diagnosed, the patient should be referred to an appropriate specialist. If the cause of neck mass remains unknown and in the case where a definite diagnosis by a histopathologist is needed (limfoma), an open biopsy should be considered. Open biopsy should only be performed by a physician that is capable of managing the complications which may arise, and is trained in surgical removal of cervical lymph nodes.
Summary		Podana sta kratek pregled najpogostejših bolezni, ki se kažejo kot otekline na vratu, in napotki, kako naj se bolnik z oteklino na vratu stopenjsko obravnava. Pri otrocih in mlajših odraslih je oteklina največkrat posledica vnetno spremenjenih bezgavk. Te bolnike zdravi specialist splošne/družinske medicine. Bolnike s povečanimi bezgavkami na vratu, ki se na antibiotično zdravljenje v 3-4 tednih ne odzivajo, je treba napotiti k otorinolaringologu. Otorinolaringolog, ki lahko bolnika ambulantno z endoskopi natančno pregleda, pogosto odkrije vzrok oteklin na vratu. Večji del abscesov, prirojenih nepravilnosti, benignih in malignih tumorjev obraznega dela glave in vratu otorinolaringolog tudi operira. Če vzroka za oteklino ne odkrije, bolnika napoti na preiskave k drugim specialistom (citopatalogu za tankoigelno biopsijo, infektologu), ki običajno uspeta opredeliti bolezen. V primeru, da gre za zasevek raka, je potrebno iskanje primarnega tumorja. Če ugotovimo sistemsko bolezen, je bolnik takoj napoten k ustreznemu specialistu. Kadar ostaja vzrok otekline na vratu nepojasnjen ali če je potrebno, da histopatolog tkivo dokončno opredeli (npr. limfom), je potrebna biopsija. Dela naj jo samo tisti, ki zna obvladati zaplet, ki poseg lahko spremlja, in ki je usposobljen za operativno odstranitev bezgavk na vratu.
Descriptors		NECK LYMPHADENITIS LYMPHATIC METASTASIS HEAD AND NECK NEOPLASMS PHYSICAL EXAMINATION PALPATION