磁共振检查对脾脏淋巴瘤的诊断价值  

The value of MR in the diagnosis of primary splenic lymphoma

作　　者：倪海洋[1] 张蕊[1] 卢敬红[1] 王静秋[1] 崔红升[1] 赵雪峰[1] 

机构地区：[1]齐齐哈尔市第一医院磁共振科,黑龙江省齐齐哈尔161000

出　　处：《中国基层医药》2011年第3期349-350,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨磁共振检查对脾脏原发性淋巴瘤（PSL）的诊断价值。方法经手术病理证实的脾脏PSL患者3例，均采用磁共振检查，分析其影像学表现及诊断情况。结果3例手术后病理诊断均为B细胞型非霍奇金淋巴瘤，磁共振检查表现为多发肿块型2例，巨块型1例；磁共振平扫表现为脾脏不规则增大，呈等／稍长T1稍短T2信号巨大肿块影像，脾周围见线样长T1、长T2信号，脾门血管被包绕；增强扫描后，脾脏病变不均匀强化，呈等、低混杂信号，腹膜后病变呈中等均匀强化。免疫组化提示弥漫大B细胞型2例，肿瘤细胞CD20及CD19α弥漫（＋）、CD3、CD5散在（＋）、CD43（＋）、CD45RO（＋）、CD10（＋／-）、Mum（＋）、MAC387散在（＋），B系淋巴浆细胞型1例，CD79eL（＋）、CD23（＋）、CD38（＋）、λ（＋）。结论PSL的磁共振表现具有特征性，有助于明确诊断，确诊依靠手术病理和免疫组化检查。Objective To evaluate the value of MR in the diagnosis of primary splenic lymphoma （PSL）. Methods The MR imaging features of 3 PSL cases proved by pathology were retrospectively reviewed. Results Three cases were all pathologically diagnosed as B-cell non-Hodgkin＇s lymphoma（NHL）. Two cases were multiple node shape and one was massive shape. Unenhanced MR imaging revealed heterogeneous splenic enlargement, with large nodules showing iso-hyperintemse on T, WI and hypointense on T2WI. Linear hyperintense on T1WI and T2WI was seen on the spleen perlpherous. The spleen vascular was infiltrated. CE-MRI showed heterogeneous enhancement of spleen with iso-hypointense. The focus of postperitoneal showed medial enhancement. Immunohistochemistry showed 2 cases of diffuse B cell. The CD20 and CD19 α of tumor cell showed diffuse（ ＋ ） ,CD3 ,CD5 individual（ ＋ ） ,CIM3 （ ＋ ） ,CD45RO（ ＋ ） ,CD10（ ＋/- ） ,Mum（ ＋ ） ,MAC387 individual（ ＋ ） ,1 case of B lymphocell type, CD79ct （ ＋ ） ,CD23（ ＋ ） ,CD38（ ＋ ） ,h（ ＋ ）. Conclusion The MR imaging features of PSL were characteristic and helpful in the diagnosis of PSL,but the correct diagnosis was still dependent on the pathology and immunohistochemieal staining.

关 键 词：脾肿瘤 淋巴瘤 磁共振波谱学 

分 类 号：R733[医药卫生—肿瘤] R44[医药卫生—临床医学]