纵隔淋巴瘤与恶性胸腺瘤的影像鉴别  

作　　者：庾汉华 钟升院 张卫民[1] 谭卓[1] 

机构地区：[1]广东省东莞市黄江医院放射科,523750

出　　处：《当代医学》2012年第14期5-7,共3页Contemporary Medicine

摘　　要：目的探讨纵隔淋巴瘤及恶性胸腺瘤的影像学差异,以提高其鉴别能力。方法回顾性分析经病理证实的纵隔淋巴瘤24例及恶性胸腺瘤28例,观察各自影像学表现并进行统计学分析。结果 24例恶性胸腺瘤中,多局限于前纵隔或延伸至中纵隔,偏向纵隔一侧者20例;密度欠均匀,多发囊变坏死者22例,钙化者6例;胸膜结节状增厚者5例;均未见浅表淋巴结肿大;而24例淋巴瘤中,累及胸部多组淋巴结,跨越纵隔两侧生长;密度多均匀,囊变坏死者7例,钙化者1例;无胸膜增厚;浅表淋巴结肿大者5例,以上几点与恶性胸腺瘤组之间的差异均有统计学意义(P<0.01)。28例恶性胸腺瘤中,邻近心脏及大血管受侵者14例,大血管结构受推移者8例;胸腔积液或心包积液者12例;24例淋巴瘤组,邻近心脏及大血管受侵者16例,大血管结构受推移者8例;胸腔积液或心包积液者6例,以上两点与恶性胸腺瘤组之间的差异无统计学意义(P>0.05)。结论纵隔淋巴瘤与恶性胸腺瘤的影像学表现具有一定的特征,CT对其诊断与鉴别诊断有重要价值。Objective To investigate the imaging features and differential diagnosis of lymphoma and malignant thymoma in the mediastinum,so that to improve the correct diagnosticrate of them.Methods The imaging features of 28 patients with the mediastic thymoma and 24 patients lymphoma confirmed by pathology were analysed retrospectively.Statistic analysis on several imaging features was performed in two groups.Results The thymomas were located at the anterior mediastinum or extension to middle mediastinum from anterior mediastinum.The mass protruded a side of the medinstinum in 20 cases;the density were heterogeneous,cyst change and necrosis in 22 cases,calcification in 6 cases;5 cases of mass had the nodule sticking out in the massmarginss;there were no lymphadenovarix on the surface larger in the malignant thymoma.The most mediastic lymphoma invasived the multipe lymphaden on the chest and the mass protruded both side of mediastinum;the density were homogeneous,cyst change and necrosis in 7 cases,calcification in1 cases;there were no mass on the nodule sticking out in the massmarginss;there were 5 lesion lymphadenovarix on the surface larger in the malignant thymoma.All those differences mentioned above between malignant thymoma and lymphoma were of statistical significance（P0.01）.The neighboring vessel structures violated by the malignant thymoma in 14 cases,neighboring vessel structures were pushed by the malignant thymoma in 8 cases;there were 12 patients with hydrothorax and hydropericardium;the neighboring vessel structures violated by lymphoma in 12 cases,neighboring vessel structures were pushed by lymphoma in 6 cases;there were 6 patients with hydrothorax and hydropericardium.All those differences mentioned above between malignant thymoma and lymphoma were not of statistical significance（P0.05）.Conclusion Malignant thymoma and lymphoma are of certain characteristic CT manifestation respectively.

关 键 词：淋巴瘤 恶性胸腺瘤 纵隔 体层摄影技术 X线检查 鉴别诊断 

分 类 号：R734.5[医药卫生—肿瘤] R736.3[医药卫生—临床医学]