原发性骨淋巴瘤的影像诊断及误诊分析  

The analysis on imageology dignosis and misdiagnosis for primary lymphoma of bone

作　　者：杨东[1] 安立龙[1] 孙满顿 张习敏[1] 巩若箴[2] 

机构地区：[1]河北省安国市医院影像科,河北保定071200 [2]山东省医学影像学研究所,山东济南250021

出　　处：《医学影像学杂志》2017年第8期1550-1553,共4页Journal of Medical Imaging

摘　　要：目的探讨原发性骨淋巴瘤的影像学表现并分析误诊原因,提高其诊断水平。方法回顾性分析经病理证实的12例原发性骨淋巴瘤患者X线、CT和MRI表现。结果 12例均为非霍奇金淋巴瘤,其中10例为单发病灶,2例为多发病灶,发生于脊柱5例,股骨2例,胫骨2例,肱骨、顶骨和上颌骨各1例。病灶形态不规则10例,类圆形2例;6例CT扫描病灶CT平扫表现为软组织密度影;5例MR扫描中,T_1WI病灶呈等信号或略低信号,在T_2WI病灶呈等信号或略高信号。5例行增强扫描,轻度均匀性强化4例,不均匀强化1例。术前影像学诊断为转移瘤3例,骨结核3例,恶性骨肿瘤2例,骨肉瘤1例,恶性神经源性肿瘤1例,恶性脑膜瘤1例,上颌窦癌1例。结论原发性骨淋巴瘤的影像学表现有一定特征性,可根据这些特征与其它骨肿瘤鉴别,以减少误诊。Objective To analyze the imaging features and cause of misdiagnosis for primary lymphoma of bone, and to improve the diagnostic accuracy. Methods X-ray, CT and MRI findings of 12 cases with primary lymphoma of bone proved by pathology were retrospectively analyzed. Results All the 12 cases were non-Hodgkin＇ s lymphomas. Single lesion was seen in 10 cases and multiple lesions in 2 cases. Of the total lesions, 5 cases were located in spine, 2 cases were located in thighbone, 2 cases were located in tibia, and 1 case was located in humerus, parietal bone and maxilla respectively. 10 of 12 cases were irregularly shape, and 2 cases were round shape. On plain CT scans of 6 cases, all the lesions presented as parenchyma density. On plain MRI of 5 eases, the lesion presented as iso- or slight hypo-signal on Tl WI, while the lesion presented as iso- to slight hypersignal on T2WI. And the lesions in 4 of 5 cases were enhanced slightly and homogeneously after contrast injection, only one case showed inhomogeneous enhancement. The main misdiagnoses were metastatic tumor, bone tuberculosis, osteosarcoma, malignant neurogenic tumors, malignant meningioma, carcinoma of maxillary sinus and others malignancy of bone. Conclusion Primary lymphoma of bone has certain characteristics in its imaging appearances, which might be helpful for making the differential diagnosis and reducing misdiagnosis.

关 键 词：骨淋巴瘤 体层摄影术 X线计算机 磁共振成像 误诊 

分 类 号：R738.1[医药卫生—肿瘤] R814.42[医药卫生—临床医学]