原发性骨淋巴瘤影像学诊断及鉴别诊断  

Imaging diagnosis and differential diagnosis of primary bone lymphoma

作　　者：罗泽斌[1] 陈晓东[1] 黄泽光[1] 

机构地区：[1]广东医学院附属医院放射科,广东湛江524001

出　　处：《实用放射学杂志》2012年第10期1599-1603,共5页Journal of Practical Radiology

摘　　要：目的探讨原发性骨淋巴瘤（primarybonelymphoma，PBL）的影像学特点及鉴别诊断。方法回顾性分析12例本院经临床和病理（包括免疫组化）证实的PBL病例的x线、CT和MRI表现。结果单骨发病11例（股骨2例，桡骨1例，锁骨1例，骨盆2例，颅面骨3例，胸腰椎各1例），多骨发病1例（骶骨），共12例。X线和CT检查10例，溶骨破坏型8例，5例为虫蚀样，3例为渗透性；混合型2例，1例为溶骨硬化型，1例为囊状膨胀型；骨皮质中断9例；骨膜反应2例，1例呈层状，1例形成Codman三角；出现死骨1例；9例均见软组织肿块影。MRI检查6例，T1WI信号与肌肉相仿或稍低，T2WI呈稍高信号，尤其在T：压脂序列上。累及多椎体并侵人椎管1例，6例均有软组织肿块，范围较骨质破坏区大，增强扫描呈轻、中度均匀或不均匀强化。结论PBL具有一定的影像学特点，X线、CT和MRI有机结合有助于诊断。Objective To explore the imaging diagnosis and differential diagnosis of primary bone lymphoma （PBL}. Methods X- ray, CT and MRI findings of 12 cases with PBL proved by clinical and pathology（including immunohistochemistry） were retrospec- tively analysed. Results Among 12 cases of PBL, single lesion was detected in 11 cases （2 in femur, 1 in radius, 1 in clavicle, 2 in pelvis, 3 in craniofacial bone and 2 in vertebra）, while multiple bone infiltration was found in 1 case {sacral vertebrae）. 10 cases un- derwent X-ray and CT examination. Bone destruction appeared as osteolytic type in 8 cases, including mouse biting-like in 5 and per- meability in 3, and mixed type in 2 cases, including mixed bone dissolving and sclerosis type in one, cystic expansion type in one. There were 9 cases with bone cortex interruption affd 2 cases with periosteum reaction, which appeared as layer in 1 and Codman tri- angle in 1. Bone sequestrum was found in 1 case and soft tissue masses were found in 9 cases. 6 cases underwent MR examination. MR imaging showed that the lesions were iso- or slight hypointense contrast to muscle on T1WI and slight to moderate hyperintense on T2 WI, especially on T2 fat suppressuion sequence. Multi-vertebral bodies involved and extended into the spinal canal in 1 case. Soft tissue masses were seen in all cases with slight to medium homogeneous or heterogeneous enhancement, the extents of the soft tissue masses were wider than that of osseous destruction. Conclusion PBL has certain imaging characteristics, combined X-ray, CT and MRI findings can get more informations, which may be helpful for diagnosis.

关 键 词：骨 淋巴瘤 计算机体层成像 磁共振成像 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]