颈部Castleman病的CT特征及病理对照  

Castleman Disease on Neck: A Comparison Between Its CT Findings and Pathological Results

作　　者：马秀华[1] 薛鹏[1] 肖智博[2] 陈勇[1] 张斯佳[1] 仲继刚[1] 

机构地区：[1]郑州人民医院医学影像科,河南郑州450003 [2]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中国医学影像学杂志》2014年第12期914-917,共4页Chinese Journal of Medical Imaging

摘　　要：目的总结颈部Castleman病的CT特征,并与病理结果进行对照。资料与方法回顾性分析11例经手术病理证实的颈部Castleman病患者的CT及病理资料。结果病灶发生于颈动脉鞘区4例,颈后三角区3例,颈根部及锁骨上区2例,腮腺、纵隔及腹股沟区1例,颌下间隙1例。局限型10例,病理类型为透明血管型;弥漫型1例,病理类型浆细胞型。局限型CT平扫8例呈等密度,1例为稍低密度,1例稍高密度,密度均匀,无明显囊变坏死;增强8例动脉期呈不均匀显著强化,静脉期持续强化呈均匀高密度;2例动脉期中度强化,静脉期呈等及稍高密度。弥漫型1例平扫为稍低密度,动脉期中度强化,静脉期边缘强化较明显,中心等密度。6例动脉期边缘见血管影。结论颈部不同病理类型Castleman病的CT表现具有差异,局限型CT表现具有一定的特征:平扫多呈均匀等密度,一般无坏死、出血;增强动脉期明显强化,可见滋养血管,静脉期持续强化呈均匀高密度,仔细分析其CT征象,能做出正确诊断,弥漫型确诊需要病理检查。Purpose To investigate the CT features of Castleman disease （CD） on neck and compare them with the pathological results. Materials and Methods The CT findings and pathological data of 11 patients with CD on neck proved by pathology and surgery were retrospectively analyzed. Results There were 4 lesions located in the carotid sheath, 3 lesions in the posterior triangle area, 2 lesions in the neck root and supraclavicular region, 1 lesion in the parotid, and the other 1 case in the submandibular space. Ten patients had localized CD and their pathological results presented hyaline vascular type; the other 1 patient had diffused CD, which revealed plasma cell type. The 10 cases with localized CD all had iso-density without cystic necrosis, among which 8 showed equal density, 1 had slightly low density, and the rest 1 had slightly high density. The contrast- enhanced scan showed that 8 cases had intense heterogeneous enhancement at arterial phase and increasingly intense homogenous enhancement at intravenous phase; the other 2 cases showed heterogeneous moderate enhancement at arterial phase and homogenous and slightly high density at intravenous phase. As to the 1 case of diffused CD type, the plain scan revealed slightly low density, the enhanced scan showed moderate homogeneous density at arterial phase, and intense enhancement at the edge with homogenous density at the center at intravenous phase. Six cases could be seen vascular shadow at the edge at arterial phase. Conclusion The CT manifestations of CD on neck of different histological type were different. Specifically speaking, the plain scan reveals that localized CD type often has the features like homogenous density without necrosis or hemorrhage; the enhanced scan shows intense enhancement and visible nourished blood vessels at arterial phase, and displays continuous intense enhancement with homogenous high density at intravenous phase. A careful analysis of its CT findings could be helpful in making correct diagnosis. However, pathological examination

关 键 词：巨淋巴结增生 颈 体层摄影术 螺旋计算机 病理学 外科 

分 类 号：R323.1[医药卫生—人体解剖和组织胚胎学] R445.3[医药卫生—基础医学]