眶内原发非霍奇金淋巴瘤的影像学特征及病理学分析  

Imaging features and pathological analysis of the primary orbital non-Hodgkin's lymphoma

作　　者：王超[1] 王晓明[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2015年第8期542-547,共6页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨原发于眶内的非霍奇金淋巴瘤的影像学特征及临床病理学特点。方法:回顾性病例研究,2008年1月—2014年12月我院眼科共收治9例眶内原发非霍奇金淋巴瘤患者,且均经手术病理证实。全部病例均行双眼超声检查,8例行双眼或眶骨CT检查,7例行眼部MRI扫描,其中4例行MRI增强扫描,1例行18F-FDG PET/CT检查。结果 :全部病例均未侵及球内及视神经,9例中有5例肌锥内外间隙均受累,且以肌锥外间隙为主,单纯累及肌锥内、外间隙各1例;5例病灶以球周为主,3例位于球后,1例位于球前眼睑部,其中1例弥漫性生长者伴眶骨的溶骨性破坏;7例超声提示为占位或肿块;6例CT显示为密度均匀的软组织肿块,局部边缘呈浸润状;平扫MRI呈等或稍长T1、T2均质信号强度,近似眼外肌,增强扫描病灶均匀强化,1例骨质破坏者可清晰的显示肿瘤向颅内侵袭;1例术后行PET/CT检查,球前眼睑处18F-FDG代谢增高,SUVmax=2.4,提示病灶残留。病理结果依据最新WHO分类标准:5例为黏膜相关淋巴组织B细胞淋巴瘤(MALT),1例弥漫性大B细胞淋巴瘤(DLBCL),1例滤泡细胞淋巴瘤(FL),1例T淋巴母细胞瘤(T-LBL),1例NK/T细胞淋巴瘤(NK/T)。结论 :眶内原发非霍奇金淋巴瘤的影像学(超声、CT及MRI)检查结果有一定的特征性,PET/CT可对肿瘤术后疗效进行评估,恶性程度高的病理学类型侵袭性较强,单纯依靠影像学诊断的准确率不高,需结合病理以及免疫组化。Objective： To study the imaging and pathological features of the primary orbital non-Hodgkin＇s lymphoma. Methods： It was a retrospective case series study. Nine patients with the primary orbital non-Hodgkin＇s lymphoma were surgically treated in our hospital from January 2008 to December 2014, and had been pathologically confirmed. All patients were performed with uhrasonography, 8 cases with CT, 7 cases with MRI, in which 4 cases with enhanced MRI, 1 case with ^18F- FDG PET/CT scan. The data of imaging and pathology were retrospectively analyzed. Results： The inner ball and optic nerve were not invading in all cases. The .lesions in 5 of 9 cases located in both of intra- and extra-conal space, and mainly in extraconal one. An intra- and extra-conal involvement of each case. Five cases of lesions involved mainly in peribulbar, 3 cases located behind the ball and 1 case in the eyelid of the ball, destruction of orbital bone was evident in 1 case with diffuse lesions. In 7 of 9 with ultrasonography were considered as occupying or mass, uniform density of soft-tissue mass with local infiltration shaped edges were showed on plain CT film in 6 cases. The signal intensity of the lesions was equal or slightly long T1, T2 homogeneous signal intensity, similar to the extraocular muscles, homogeneous enhancement in enhanced MR scan, intracranial invasion was prompted by the bone destructive lesion. The patient who was performed with postoperative PET/CT, the metabolism of ^18F-FDG increased as SUVmax=2.4 in the eyelid, suggesting the lesion residue. According to the new WHO classification of lymphoma： 5 cases of B cell of mucosa-associated lymphoid tissue lymphoma （MALT）, each one of diffuse large B-cell lymphoma（DLBCL）, follicular lymphoma（FBL）, T-cell lymphoblastoid lymphoma（T-LBL） and nature killer/T cell lymphoma （NK/T）. Conclusion： The imaging （ultrasound, CT and MRI） of the primary orbital non-Hodgkin＇s lymphoma is characteristic, the efficacy of lymphoma surgery can be evaluate

关 键 词：眶肿瘤 淋巴瘤 非霍奇金 超声检查 体层摄影术 X线计算机 磁共振成像 正电子发射断层显像术 

分 类 号：R739.72[医药卫生—肿瘤] R445.1[医药卫生—临床医学]