鼻腔恶性淋巴瘤的CT诊断价值  

Diagnostic value of CT scans for malignant lymphoma of nasal cavity

作　　者：蔡爱群[1] 陈俊伟[1] 李仰康[1] 陈雪吟[1] 周修国[1] 

机构地区：[1]汕头大学医学院附属肿瘤医院放射科,广东汕头515031

出　　处：《中国临床医学影像杂志》2010年第4期240-243,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨鼻腔恶性淋巴瘤的CT表现,旨在提高其诊断准确性。资料与方法:回顾性分析经病理证实的27例鼻腔淋巴瘤的CT表现。结果:根据2001年WHO淋巴瘤分类方法,27例均为非霍奇金淋巴瘤(NHL),其中B细胞淋巴瘤4例,T细胞和NK/T细胞性淋巴瘤22例,1例NHL未分型。CT表现:①病变绝大部分位于鼻腔前部(13/27)和前中部(6/27),密度均匀,呈膨胀性生长,未见坏死液化。多伴有鼻翼、鼻背、面颊部软组织增厚、肿胀或肿块(24/27)。②向周围蔓延,浸润筛窦(15/27)、上颌窦(6/27)、蝶窦(4/27)、颞下窝(2/27)、翼腭窝(2/27)、眼眶(2/27)、鼻咽(2/27)等。③骨质破坏少而轻,一般上颌窦前壁未见破坏。④鼻前庭受累少(3/27)。⑤颈部淋巴结受累少(3/27)。⑥放化疗后,短期内病灶明显缩小或消失(14/16)。结论:鼻腔NHL具有一定的CT影像特征,CT扫描能直观全面地显示病变的侵犯范围和程度,为临床分期和治疗方案的制定提供可靠的依据。Objective： To investigate the CT findings of malignant lymphoma in nasal cavity and to improve the diagnostic accuracy of CT on this disease. Materials and Methods： The CT presentations of 27 cases with nasal lymphoma proved by pathology were retrospectively analyzed. Results： According to lymphoma classification of WHO in 2001, all cases were nonHodgkin lymphoma （NHL）. Four cases were B-cell lymphoma, 22 cases were T-cell or NK/T-cell lymphoma and 1 case was lymphoma untyping. CT findings were summarized as the following 6 points. Firstly, the majority of the lesions were located in anterior （13/27） or anterior-middle part （6/27） in nasal cavity, homogeneous in density, expansive growth without necrosis. Soft tissue thickening, swelling or mass of nasal ala, nasal dorsum and cheeks were detected in most cases （24/27）. Secondly, lesions invaded surrounding tissues, including ethmoidal sinus（15/27）, maxillary sinus（6/27）, sphenoidal sinus（4/27）, infratemporal fossa（2/27）, pterygopalatine fossa（2/27）, orbit（2/27） and nasopharynx（2/27）. Thirdly, bony destruction was mild and destruction of anterior wall of maxillary sinus could not be detected. Fourthly, nasal vestibule invasion seldom occurred（3/27）. Fifthly, cervical lymph nodes metastasis was uncommon （3/27）. Sixthly, lesions obviously contracted or disappeared in short term after radiochemotherapy （14/16）. Conclusion： Nasal NHL has some certain CT characteristics. CT can directly and comprehensively demonstrate the extent and degree of invasion and provide reliable information to clinical staging and therapy.

关 键 词：淋巴瘤 鼻肿瘤 体层摄影术 螺旋计算机 

分 类 号：R733.4[医药卫生—肿瘤] R739.62[医药卫生—临床医学]