原发性肾上腺淋巴瘤的影像学表现  

CT imaging features of primary adrenal lymphoma

作　　者：岳婧婧[1] 宋琦[1] 迟婧[1] 严福华[1] 方文强[1] 赵夏[2] 王黎[2] 赵维莅[2] 

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,上海200025 [2]上海交通大学医学院附属瑞金医院血液科,上海200025

出　　处：《实用放射学杂志》2016年第1期48-51,共4页Journal of Practical Radiology

基　　金：国家临床重点专科建设项目;上海高校一流学科（B）类建设项目.

摘　　要：目的 分析原发性肾上腺淋巴瘤（PAL）的影像学表现及特点，并与肾上腺其他常见肿瘤鉴别。方法 回顾性分析7例经临床及病理证实的PAL；5例证实为弥漫大B细胞淋巴瘤（DLBCL），2例证实为外周T细胞淋巴瘤（PTCL）；患者均行CT检查，观察其CT特点。结果 7例患者，共12个肿瘤；双侧肿瘤5例，单侧肿瘤2例，肿瘤直径范围4.4~14.2 cm，中位数为6.5 cm；肿块型11个，类肾上腺型1个；平扫11个肿瘤呈低密度，1个呈等密度；增强后动脉期9个肿瘤为轻度强化，3个肿瘤为中度强化；门脉期12个肿瘤均为中度强化；其中有3个肿瘤强化不均，2个肿瘤境界不清，2个肿瘤累及周围结构，1例伴有腹膜后淋巴结肿大。结论 PAL好发双侧，影像表现为体积较大的软组织块影，密度较均匀，增强后为渐进性轻中度强化。Objective To analyze the imaging manifestation and features of primary adrenal lymphoma （PAL） in order to differentiate it from other adrenal tumors. Methods 7 patients with primary adrenal lymphoma proved by clinic and pathology were retro-spectively reviewed. 5 patients were comfirmed as DLBCL, while 2 patients were comfirmed as PTCL. All of them underwent CT scan and the imaging features were analyzed. Results There were 12 lesions in 7 cases, including 5 bilateral lesions and 2 unilateral lesions. The diameter ranges of the lesions were from 4.4 to 14.2 cm, with a mean diameter of 6.5 cm. 11 lesions were phymatoid, while 1 lesion was similar to the adrenal gland. From the unenhaneed CT images, 11 lesions manifested as low-density and 1 lesion as isodensity. After intravenous injection of contrast media, 9 lesions enhanced slightly and 3 lesions enhanced moderately in arterial phase. Then 12 lesions enhanced moderately in portal venous phase with 3 heterogeneous enhancement, 2 dim boundary, 2 infiltra ring the adjacent tissues and blood vessels, and 1 with enlarged retroperitoneal lymph nodes. Conclusion Primary adrenal lymphoma usually manifests as bilateral, homogeneous, large soft tissue mass with mild to moderate enhancement.

关 键 词：淋巴瘤 肾上腺肿瘤 计算机体层成像 磁共振成像 

分 类 号：R733.4[医药卫生—肿瘤] R736.6[医药卫生—临床医学]