Castleman病的CT表现及临床病理特点  

Castleman disease:computed tomography and clinical findings

作　　者：范舒璇[1] 叶兆祥[1] 孟晓燕[1] 马菊香[1] 

机构地区：[1]天津医科大学肿瘤医院放射科/国家肿瘤临床医学研究中心/天津市肿瘤防治重点实验室,天津300060

出　　处：《放射学实践》2014年第6期647-650,共4页Radiologic Practice

摘　　要：目的:探讨Castleman病(CD)患者的临床病理特征、CT表现特点及预后。方法:回顾性分析经手术或活检病理证实并行CT检查的24例CD患者的CT资料和临床资料,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:24例中透明血管型15例,浆细胞型8例,混合型1例。15例透明血管型CD临床分型均为单中心型,包括胸部7例、颈部4例、腹膜后2例、盆腔及腹股沟2例,8例浆细胞型CD均为多中心型。透明血管型CD CT表现为边界清楚的软组织密度肿块,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,延迟期仍有强化。3例肿瘤周围见丰富的强化血管影。浆细胞型CD CT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。透明血管型CD术后均无复发,而浆细胞型CD预后多种多样。结论:CD的CT表现与临床类型、病理分型密切相关。CT对透明血管型CD的诊断具有较高的准确性,尤其是肿瘤内部的钙化及增强CT表现具有重要诊断价值,手术治疗效果好,预后佳;而浆细胞型CD缺乏特征性,确诊需要结合病理学,且预后差。Objective：To analyze the clinicopathological characteristics,CT imaging features and prognosis of Castleman disease.Methods：Twenty-four patients with lymph node biopsy-proved or surgery-proved Castleman disease were retrospectively reviewed in this study.Clinicoradiological findings of the 24 patients were analyzed.Results：Of 24 patients,hyaline-vascular type （HVT）was found in 15 patients,plasma cell type （PCT）in 8 patients,and mixed type in one patient.The 15 cases of HVT were soloitary,whereas the PCTs were multicentric.In 15 cases of HVTs,7 were in chest,4 in neck,2 were in retroperitonum and 2 were in groin and pelvis.HVT showed well circumscribed masses with soft-tissue density, punctate or bifurcate calcification and linear low-density areas on non-enhanced CT images.All masses showed significant enhancement in arterial phase and residual enhancement in delayed phase.PCT manifested as multiple enlarged lymph nodes,the masses showed homogeneous density and contrast enhancement but appeared to show less enhancement than HVT.The diseases were cured with surgical removal in HVT,whereas they showed variable prognosis in PCT.Conclusions：CT manifestations of CD are closely correlated with the clinical and pathological types.CT has a higher accuracy and great value in the diagnosis of hyaline-vascular type CD,especially the calcification and contrast-enhancement patterns for differential diagnosis.HVT showed good prognosis after surgical treatment,while the plasma cell type was non-specific on CT and showed variable prognosis.

关 键 词：巨淋巴结增生 体层摄影术 X线计算机 预后 

分 类 号：R551.2[医药卫生—血液循环系统疾病] R816[医药卫生—内科学]