胸部何杰金氏病和非何杰金淋巴瘤X线鉴别诊断  

X-ray Differential Diagnosis of Intra-thoracic Hodgkin’s Disease and Non-Hodgkin’s Lymphoma

作　　者：徐健[1] 陈秀琴[2] 罗中华[1] 贺洪德[1] 

机构地区：[1]第四军医大学西京医院放射科,陕西西安710032 [2]汉中市人民医院影像中心

出　　处：《实用放射学杂志》2008年第9期1199-1201,1204,共4页Journal of Practical Radiology

摘　　要：目的探讨胸部恶性淋巴瘤何杰金氏病(HD)和非何杰金淋巴瘤(NHL)的X线特征及鉴别要点。方法回顾性分析66例有完整临床及病理资料的胸部恶性淋巴瘤(其中HD20例,NHL46例)的X线表现。重点观察肺门与纵隔淋巴结肿大、肺内及胸膜的改变,并与其相关病理资料对照。结果(1)48例出现肺门和/或纵隔淋巴结肿大表现,以NHL多见,呈单侧或非对称性肿大改变。HD则少见,且多呈双侧或对称性肿大改变。(2)HD常侵犯前纵隔和胸骨后组淋巴结,NHL则多侵犯后纵隔淋巴结组并致脊柱旁线增宽。(3)肺内改变多为间质性病变,以NHL多见,HD少见。(4)胸膜改变以NHL多见,HD少见。结论胸部HD和NHL的X线表现各有特征,仔细观察和分析这些特征,有利于二者的鉴别。Objective To investigate the X -ray characteristics and differential points of intra- thoracic malignant lymphoma- Hodgkin＇ s disease（ HD} and Non - Hodgkin＇ s lymphoma（ NHL）. Methods The X - ray manifestations of intra - thoracic malignant lymphoma in 66 eases（ including HD in 20 and NHL in 46） with complete clinical informations and pathologic results were retrospectively analysed. The lymphadenopathy of the hilar and mediastinum, the changes of the intra - lung and pleura were mainly observed and compared with the pathological results. Try to find the characteristic X - ray appearance of the HD and NHL. Results （ 1 ） 48 cases had enlargmnent of lymph nodes of the hilar with/or mediastinum,and common seen in NHL,and the lymphopathy appeared as unilateral or asymmetry in NHL, bilateral or symmetry in HD. （2）The involvement of lymph nodes was mostly the anterior mediastinum and retrosternal in HD, the posterior mediastinum in NHL and to cause the paraspinal line widening. （ 3 ） Intra - pulmonary lesions always were interstitial changes and common seen in NHL,and seldom seen in HD. （4） NHL was often accompanied with pleural lesions,and HD not. Conclusion Both HD and NHL have its own X - ray characteristics . Carefully observing and analyzing these characteristics are helpful in diagnosing and differentiating HD and NHL.

关 键 词：胸部 淋巴瘤 何杰金氏病 非何杰金淋巴瘤 X线摄影 

分 类 号：R733.1[医药卫生—肿瘤] R733[医药卫生—临床医学]