巨淋巴结增生症的多层螺旋CT表现  

Multi-slice spiral CT findings of Castleman disease

作　　者：李佩玲[1] 常妙[1] 刘婷[1] 韩昱晨[2] 王强[1] 赵丽[1] 徐克[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001 [2]中国医科大学附属第一医院病理科,沈阳110001

出　　处：《中华放射学杂志》2013年第1期64-67,共4页Chinese Journal of Radiology

摘　　要：目的探讨巨淋巴结增生症（CD）患者的CT表现特点。方法回顾性分析经手术或活检病理证实并行CT检查的22例CD患者资料，并将CT影像表现与病理结果进行对照，分析其CT表现特点。结果临床分型局限型18例，包括胸部5例、腹膜后8例、盆腔及腹股沟5例；弥漫型4例。18例局限型CD病理分型均为透明血管型，CT表现为软组织密度肿块，平扫CT值为（45±16）HU，边缘清晰，内部可见斑点状、分叉状钙化及灶状或条状低密度区；增强后动脉期肿块即明显强化，CT值平均升高（56±22）HU，延迟期仍有强化，内部低密度灶更明显。强化方式呈均匀强化、渐进式强化和不均匀强化3种。4例肿瘤周围见丰富的强化血管影。4例弥漫型病理分型均为浆细胞型，表现多发淋巴结肿大，密度均匀，增强后亦明显强化，但较透明血管型强化程度低，CT值平均上升（32±10）HU。结论局限型CD的CT表现具有一定的特征，尤其是肿瘤内部的钙化及增强CT表现具有重要诊断价值；弥漫型CD的CT表现缺乏特征性。Objective To analyze the CT imaging features of Castleman disease and enhance our knowledge of Castleman disease. Methods Twenty two patients with lymph node biopsy-proved or surgery- proved Castleman disease were retrospectively reviewed in this study. Of the 22 patients, 18 had localized lesion and 4 patients had muhicentric lesions. Correlation was made between CT and pathologic findings. Results Eighteen patients with localized Castleman disease had the hyaline-vascular type and showed well- circumscribed masses with soft-tissue density [ mean CT value, （ 45± 16 ） HU ], punctate or bifurcate calcification and linear low-density areas on non-enhanced CT images. All localized masses showed significant enhancementwith an increase of（ 56 ± 22 ）HU on arterial phase and showed residual enhancement and some low-density areas on delayed phase. Enhancing patterns were variable, including homogeneous enhancement, gradual enhancement from the edge to the center of mass and heterogeneous enhancement. Four patients with localized lesion demonstrated enhancing vessels around masses. Four patients with muhicentric CD belonged to the plasma cell type and had multiple enlarged lymph nodes. Plasma cell type masses with homogeneous density also showed enhancement after injection of contrast media but appeared to reveal a less increase of （ 32 ±10 ） HU than the hyaline vascular type. Conclusions The localized Castleman disease showed certain characteristics on CT imaging includingcalcification and contrast enhancing patterns, which could help in the differential diagnosis of this disease. The multicentric Castleman disease did not reveal any useful imaging features.

关 键 词：巨淋巴结增生 体层摄影术 X线计算机 

分 类 号：R55[医药卫生—血液循环系统疾病]