透明血管型Castleman病的CT诊断  

CT Diagnose of the Hyaline-vascular Type of Castleman Disease

作　　者：向先俊[1] 刘鹏程[1] 言伟强[1] 黄嵘[1] 王成林[1] 

机构地区：[1]北京大学深圳医院医学影像科,广东深圳518036

出　　处：《罕少疾病杂志》2013年第4期13-15,43,共4页Journal of Rare and Uncommon Diseases

摘　　要：目的评价透明血管型CaStleman病的CT表现。方法回顾性分析8例经手术病理证实的透明血管型Castleman病患者的CT表现，总结其特征。结果8个病例均为局限型。8例中7例为单发病灶，其中4例位于腹部，2例位于颈部，1例位于纵隔；另1例为多发病灶，位于纵隔、锁骨上窝及腋窝（同一淋巴链区）。病灶大小1．98．3cm不等，CT平扫病变表现为界限清晰，密度均匀的实性肿块，无坏死区；增强扫描动脉期病变显著强化（cT值范围103194Hu），但中心区可见条片状或裂隙样较低强化区；静脉期持续强化且趋向均匀（CT值范围94186Hu）。结论纵隔、颈部或腹部的肿块病变，界限清晰，无坏死，动态增强扫描呈“快进慢出”显著强化，提示透明血管型CaStleman病的诊断。Objective To analyse the computed tomographic（CT） findings of the hyaline vascular type of Castleman disease. Methods CT imagings of 8 patients with Castleman disease（hyaline vascular type） proved by surgery pathology were retrospectively reviewed. Results All 8 cases were localized Castleman disease. 7 of them had single lesion, located in abdomen（4 cases）, cervix（2 cases） and mediastinum（1 cases）. The rest had several lesions and located in the mediatsinum, supraclavicular fossa and armpit, which were in the same lymphatic chain. All lesions manifested as well-circumscribed and homogenous masses with the size from 1.9 cm to 8.3 cm on plain CT images. On dynamic contrast CT images, the lesions showed marked enhancement（CT values ranged from 103-194Hu） but with central stripe or cleft hypodense areas at arterial phase, and showed homogenous enhancement（CT values ranged from 94-186Hu） at venous phase continously. Conclusion The hyaline-vascular type of Castleman disease should be suspected when there was a well-circumscribed mass without necrosis in mediastinum, cervix or abdomen, and showed the marked ＂fast-washin, slow-washout＂ enhancement pattern on dynamic contrast CT scan.

关 键 词：CAST lman病 纵隔 颈部 腹部 体层摄影术 X线 计算机 

分 类 号：R73[医药卫生—肿瘤] R814.42[医药卫生—临床医学]