原发性乳腺淋巴瘤的CT及MR表现  

CT and MR Imaging manifestation of primary breast lymphoma

作　　者：董珉[1] 沈文荣[1] 郭震[1] 王美芹[1] 

机构地区：[1]江苏省肿瘤医院CT室,江苏南京210009

出　　处：《医学影像学杂志》2013年第12期1931-1935,共5页Journal of Medical Imaging

基　　金：江苏省卫生厅指导性科研项目基金资助(Z201209)

摘　　要：目的探讨原发性乳腺淋巴瘤的CT及MR特征,提高对本病影像学表现的认识。方法回顾性分析经病理证实的14例原发性乳腺淋巴瘤患者的CT及MR资料,年龄32~77岁,中位年龄54岁。所有患者皆行CT增强扫描,其中6例行MR检查。结果 14例病灶大小2.2~11.5cm。所有病变密度或信号均匀,未见毛刺及钙化。其主要有三种表现:①单发结节或肿块型:占64.3%(9/14)。增强CT除1例呈环形伴结节样强化外,其他皆均匀中等度强化。乳头未见凹陷,皮肤未见增厚,乳后间隙未见侵犯。MRI脂肪抑制T2WI表现为稍高信号,DWI显示扩散明显受限,ADC值显著降低,约0.45×10-3 mm2/s^0.73×10-3 mm2/s,时间-信号曲线均呈平台型(Ⅱ型)曲线;②多发肿块型:占14.3%(2/14)。病灶直径较大,为数个结节融合所致。密度信号改变同单发结节或肿块型相似,但占位效应明显,乳后间隙狭窄;③弥漫型:占21.4%(3/14)。病灶直径巨大,范围广泛,可累及两个乳腺象限至整个乳腺,占位效应最明显。病灶强化不均匀,MR脂肪抑制T2WI见高信号分隔,增强后分隔明显强化,可伴有乳后间隙受侵,皮肤广泛增厚,但乳头未见凹陷。结论原发性乳腺淋巴瘤的影像学表现具有一定的特征性。当出现乳腺内无毛刺及钙化的结节、肿块,MRI T2WI脂肪抑制序列呈稍高信号,ADC值显著降低、或伴一侧乳腺皮肤广泛增厚而无乳头凹陷,应考虑原发性乳腺淋巴瘤可能。Objective To analyze the imaging features of CT and MRI with primary breast lymphoma in order to improve our understanding of imaging manifestations of primary breast lymphoma. Methods Totally, 14 patients （aged 32～77, the mean age was 54 years old） with primary breast lymphoma confirmed histopathologically were retrospectively re viewed. CT imaging features of all patients and MR imaging features of 6 patients were evaluated. Results 14 lesions sized 2.2～l 1.5 cm were found. All cases showed homogenous density or signal without spiculation or calcification. There were three typical imaging findings： ① 64.3 percent （9/14） of the lesions showed single solitary nodular or mass. En hanced CT of all cases showed moderately homogenous enhancement except one lesion with heterogeneous ring enhance ment. There was no skin thickening, nipple inversion and endangered retromammary space. T2WI fat suppression se quences demonstrated slightly higher signal lesions. The apparent diffusioh coefficient （ADC） values ranged from 0.45 X 10^- 3 m㎡/s to 0.73 × 10 ^3 m㎡/s. The curve of time-signal intensity was platform pattern; ② 14.3 percent （2/14） of the lesions showed multi-mass. The diameter of lesions was larger because of nodules fusion. The density or signal was similar to the type of single solitary nodular or mass, but the space occupying lesions were obvious; ③ 21.4 percent （3/14） of the lesions showed diffuse mass. The diameter of lesions was large. The lesions were widely ranged two quadrants of breast to all breast. The space occupying lesions were the most serious. The lesions showed intensely and heterogeneously enhan cing masses. T2WI fat suppression sequences demonstrated high signal seperated lesions and the seperated lesions were significantly enhanced, with skin thickening and retromammary space endangered, without nipple inversion. Conclusion Primary breast lymphoma has some imaging characteristics; a single nodular, mass without spiculation or calcification; T2 WI fat suppres

关 键 词：乳腺肿瘤 淋巴瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R737.9[医药卫生—肿瘤] R814.42[医药卫生—临床医学]