原发性鼻腔淋巴瘤的临床与CT表现分析  

CT features of primary nasal lymphoma

作　　者：鲁际[1,2] 张安莹[2] 向超 喻红[1] 

机构地区：[1]武汉大学基础医学院,湖北430071 [2]湖北省宜昌市中心人民医院放射科,宜昌443003

出　　处：《影像诊断与介入放射学》2013年第2期83-86,共4页Diagnostic Imaging & Interventional Radiology

摘　　要：目的回顾性分析原发性鼻腔淋巴瘤的临床表现与CT特点,探讨鼻腔淋巴瘤相对特异的表现。方法回顾性分析21例病理证实的原发性鼻腔淋巴瘤的临床、病理及CT表现。结果 21例原发性鼻腔淋巴瘤病理上均为非何杰金淋巴瘤(NHL),其中9例为NK/T细胞淋巴瘤,4例为T细胞淋巴瘤,2例为B细胞淋巴瘤,1例为鼻黏膜相关淋巴瘤,5例未分型。CT显示原发性鼻腔淋巴瘤多发生于鼻腔前部外侧壁,主要累及中下鼻甲,肿块多沿鼻甲形状蔓延生长;15例发生于单侧,6例发生于双侧;16例密度均匀,5例密度不均。增强扫描呈轻中度不均匀强化;鼻前庭皮肤受累8例;NK/T细胞淋巴瘤中骨质破坏3例,6例未见明显骨质破坏,2例B细胞淋巴瘤中鼻甲及钩突骨质部分吸收,鼻窦受累9例;经放、化疗后19例好转,其中2例行单纯化疗先好转后复发,1例未愈,1例放弃治疗。结论 CT发现单侧鼻腔前部肿物,主要位于中下鼻甲,密度均匀,鼻前庭皮肤受侵,应考虑鼻腔淋巴瘤的可能。CT能直接全面地显示病变的侵犯范围及程度,淋巴结受累的情况,结合临床表现及并发症的观察,可以做出较为可靠的诊断,并对治疗及疗效评估、随访提供帮助。Objective To assess the CT features of primary nasal lymphomas. Methods The clinical, pathological and CT features of 21 histologically confirmed primary nasal Non-Hodgkin＇ s lymphomas （NHL） were retrospectively analyzed. Results The tumor cell types included 9 NK/T cell, 4 T cell, 2 B cell, 1 mucosa associated lymphoid tissue, and 5 undifferentiated. CT showed unilateral （15） or bilateral （6） masses in the anterior nasal cavities extending to the inferior and/or medial eoncha nasalis. The masses were homogeneous （16）or heterogeneous （5）in densities with mild or moderate heterogeneous contrast enhancement. There was tumor invasion of the nasal sinus （9）, skin （8）, bone （3）, medial eoncha nasalis and uneinate process （2）. Of 20 patients who completed chemo- and radiotherapy, 19 had complete response with 2 relapses, 1 did not respond to treatment. Conclusions Nasal lymphoma often involves the anterior nasal cavity including the inferior and/or medial concha nasalis and adjacent skin. CT demonstrates the tumor extent and is helpful for staging and assessment of treatment response.

关 键 词：鼻腔 淋巴瘤 体层摄影术 X线计算机 

分 类 号：R739.62[医药卫生—肿瘤]