儿童原发性肠道淋巴瘤的超声表现及其临床意义  

Ultrasonographic features and clinical characteristics of children primary intestinal lymphoma

作　　者：周蔚[1] 夏焙[1] 陈伟玲[1] 许娜[1] 陶宏伟[1] 于红奎[1] 林洲[1] 刘磊[1] 邓锦龙[1] 宋建明[2] 李灵珊 

机构地区：[1]深圳市儿童医院超声科,518026 [2]深圳市儿童医院病理科,518026

出　　处：《中华医学超声杂志（电子版）》2016年第11期815-820,共6页Chinese Journal of Medical Ultrasound(Electronic Edition)

摘　　要：目的探讨超声在儿童原发性肠道淋巴瘤诊断中的价值。方法选择2011年1月至2016年6月深圳市儿童医院儿童原发性肠道淋巴瘤的患儿12例,与手术病理检查结果对照,对患儿临床及术前超声表现进行分析。结果术前超声显示,12例原发性肠道淋巴瘤分别位于回盲部5例、回肠2例、空肠3例、横结肠1例、升结肠1例;其中8例超声表现为肠管局部低回声或极低回声肿块,与肠壁分界不清,彩色多普勒显示血流信号丰富呈点、条状,术前表现为肿块型肠肿瘤;4例超声表现为沿肠管长轴方向分布的弥漫性肠壁增厚,呈均匀或不均的低回声或极低回声,局部肠蠕动减弱或消失,肠腔内呈狭长、固定的气体高回声,彩色多普勒示血流信号丰富,术前表现为弥漫型肠肿瘤。12例患儿的肿块内均未显示明显的液性无回声区及钙化强回声。手术病理均确诊为非霍奇金淋巴瘤(伯基特淋巴瘤8例,滤泡性淋巴瘤2例,弥漫大B细胞性淋巴瘤1例,B淋巴母细胞性淋巴瘤1例)。结论儿童原发性肠道淋巴瘤多以急腹症为主要临床表现,超声表现有助于识别肠原发病变,对提高儿童肠道淋巴瘤的早期诊断、改善预后有积极作用。Objective To evaluate the value of ultrasonography in the diagnosis of primary intestinal lymphoma（PIL） in children. Methods Twelve children with PIL confirmed by clinical manifestations, surgery, pathological examination in Shenzhen Children？s Hospital from January 2011 to June 2016 were enrolled. Preoperative ultrasonic image manifestations of PIL were analyzed and compared with clinical manifestations and results of pathological examinations. Results In 12 cases of the PIL, lesions were located at the ileocecum in 5 cases, at the ileum in 2 cases, at the jejunum in 3 cases, at the transverse colon in 1 case and at the ascending colon in 1 case. There were two types of preoperative ultrasonic features of PIL including massive type（8 cases） and infiltrative type（4 cases） intestinal tomour. Sonography of massive type cases manifested as hypoechogenicity or extremely hypoechogenicity, indistinct boundary and rich blood flow signals, and infiltrative type cases showed diffuse thickening of the bowel wall with a central echogenic region caused by air, hypoechogenicity or extremely hypoechogenicity, inhomogenous echogenicity in some cases, indistinct boundary, intestinal peristalsis weaken or vanish and rich blood flow signals. Effusion and calcification were not found in all cases. All the cases were diagnosed as non-Hodgkin？s lymphoma by the pathological examinations including 8 cases of Burkitt lymphoma, 2 cases of follicular lymphoid tumor, 1 case of diffuse large B-cell lymphoma and 1 case of B lymphoblastic lymphoma. Conclusions The clinical manifestation of most children with PIL is acute abdomen. Ultrasonic image is helpful to identify the primary intestinal lesion and is important for the early diagnosis and improving the prognosis of children with PIL.

关 键 词：超声检查 儿童 肠道 淋巴瘤 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.3[医药卫生—诊断学]