25例鼻型结外NK/T细胞淋巴瘤CT表现及临床误诊原因分析  

CT Findings of 25 Cases of Extranodal NK/T Cell Lymphoma,Nasal Type and Misdiagnosis Analysis

作　　者：江超武[1] 纳玉萍[1] 高竟逾 

机构地区：[1]昆明医科大学第一附属医院耳鼻咽喉一科,云南昆明650032

出　　处：《昆明医科大学学报》2014年第7期121-124,共4页Journal of Kunming Medical University

摘　　要：目的探讨鼻型结外NK/T细胞型淋巴瘤的CT及临床特点并分析误诊原因.方法回顾性分析25例经组织学证实鼻型结外NK/T细胞型淋巴瘤的CT及临床资料.结果 25例鼻型结外NK/T细胞型淋巴瘤患者,入院前有15例在当地医院行CT检查,9例CT误诊为慢性鼻窦炎.根据病变的范围,25鼻型结外NK/T细胞淋巴瘤,局限型16例,其中14例病变位于鼻腔前部,2例位于鼻腔后段,并累及鼻咽部;弥漫型9例.根据病变的性质,病变主要表现为鼻腔内不规则软组织影,病灶较均匀、内可见不定型低密度影,增强后有强化.局限型者,鼻腔结构骨质破坏不明显,而弥漫型者,可有鼻腔中线区骨质破坏及软组织影像.14例局限型患者,病灶密度均匀者5例,9例可见不定型低密度灶,仅2例有周围骨质变薄.9例弥漫型患者,5例密度不均匀,4例增强后不均匀强化,4例病变延伸达眼眶、鼻中隔、硬腭及翼腭窝.结论鼻型结外NK/T细胞淋巴瘤,CT影像学及临床检查有一定特征性,但局限型及早期患者CT影像学特异性不明显,必须仔细结合临床,避免误诊.Objective To investigate the computed tomography （CT） and clinical characteristics of patients with extranodal natural killer/T-cell lymphoma, nasal type （ENKTL） as well as the reason of misdiagnosis. Method The CT and clinical findings of 25 patients with nasal type extranodal NK/T-cell lymphoma were retrospectively reviewed, and the reasons of misdiagnosis were analyzed to avoid it. Results Of the 25 patients, 9 of 15 patients who had a sinus CT were misdiagnosed for sinusitis before admitted to our hospital. According to the extent of tumors, 16 patients showed localized type, the localized lesions were found in the anterior nasal cavity in 14 cases and in posterior part in 2 cases. On the basis of its properties, CT showed that soft tissue density tumor filled the nasal cavity, and spread along the nasal mucosa, enhanced CT showed mild to moderate heterogeneous enhancement. For localized types, bone mass showed no obvious change; for diffuse type, bone mass destruction can be showed along the middle of nasal cavity. For localized type patients, the lesions showed homogeneous density lesion in 5 cases and inhomogeneous density in 9 cases, only 2 cases showed bone change. For diffuse type patients, the lesions showed homogeneous density lesion in 5 cases and heterogeneous enhancement after enhanced CT in 4 cases. 4 cases extended to septum and orbit and hard palate and pterygopalatine fossa. Conclusion Computed tomography （CT） and clinical findings have specific manifestation which suggest the diagnosis in nasal type extranodal NK/T-cell lymphoma patients. But for localized type cases and early stages patients, no obvious specificity can be showed by imaging findings of CT and clinical symptom. Only by CT combined with clinical symptoms we can diagnose it.

关 键 词：鼻肿瘤 NK T细胞淋巴瘤 CT 诊断 

分 类 号：R739.6[医药卫生—肿瘤]