长骨原发性恶性淋巴瘤的影像学表现  

Imaging Feature of Primary Malignant Lymphoma in Long bone

作　　者：张泽坤[1] 李玉清[1] 丁建平[1] 刘记存[1] 王冬梅[1] 王溱[1] 

机构地区：[1]河北医科大学第三医院放射科,050051

出　　处：《临床放射学杂志》2008年第8期1087-1090,共4页Journal of Clinical Radiology

摘　　要：目的探讨长骨原发性恶性淋巴瘤的影像学特点。资料与方法回顾性分析17例经临床和病理确诊的长骨原发性恶性淋巴瘤病例的X线平片、CT及MRI表现。结果男11例,女6例,平均年龄36.6岁。单发14例,多发3例。股骨受侵9例,胫骨受侵4例,肱骨、腓骨受侵各2例,桡骨受侵1例。病变位于干骺端13例次,骨干8例次。X线及CT表现为浸润型8例,溶骨型4例(其中1例股骨干为浸润型,股骨粗隆及远端为溶骨型),硬化型1例,混合型4例,囊样型1例。8例见明显骨膜反应,7例合并病理骨折,11例有明显软组织肿块。MRI检查2例均以长T1、长T2信号为主,伴有少量混杂信号。结论长骨原发性恶性淋巴瘤常侵犯单骨,干骺端及骨干为好发部位,多表现为虫蚀样浸润型和溶骨型骨质破坏,多伴有软组织肿块及骨膜反应,病变周边可伴有骨质硬化。Objective To discuss the imaging features of primary malignant lymphoma in long bone. Materials and Methods 17 cases with primary malignant lymphoma confirmed by pathology were included in the study. The plain film radiographs,CT and MR images of the patients were reviewed. Results There were 11 male and 6 female patients,age from 5 to 69 years with average of 36.6 years. The lesions involved single bone in 14 cases and multiple bones in 3 case. The lesions involved metaphysis in 13 cases and diaphysis in 8 cases. X ray films and CT findings ：lesions were infiltrative in 8 cases,osteolytic in 4 cases,sclerotic in 1 case,mixed in 4 case and cystic-expansive in 1 case. 8 cases had periosteal reaction, 7 case had pathologic fractures and 11 case had soft tissue masses. MRI finding （2 cases） ：the lesions were low signal on T1 WI and high signal on T2 WI with a small quantity of mixed signal. Conclusion Primary malignant lymphoma in long bone usually involves single bone on metaphysis or diaphysis. Mouse bite invasion, osteolytic destruction with soft tissue and periosteal reaction are the most common findings. Osteosclerosis may be found in some cases around the pathological changes.

关 键 词：非霍奇金淋巴瘤 长骨 X线摄影术 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R734.2[医药卫生—临床医学]