胸部Castleman病的MSCT表现  

MSCT findings of thoracic Castleman＇s disease

作　　者：姜天娇[1] 李伟[1] 丁兆艳[2] 户燕姣[3] 牛蕾[1] 王兰[1] 孙德政 

机构地区：[1]青岛大学附属医院黄岛院区影像科,山东青岛266555 [2]青岛大学附属医院黄岛院超声科,山东青岛266555 [3]青岛大学附属医院黄岛院病理科,山东青岛266555 [4]青岛市市立医院本部放射科,山东青岛266011

出　　处：《实用放射学杂志》2018年第2期207-210,共4页Journal of Practical Radiology

摘　　要：目的 探讨胸部Castleman病（CD）的影像学特征，旨在提高对本病的认识。方法 回顾性分析经病理证实的14例胸部CD的影像学表现，所有患者术前均行CT平扫及动态增强扫描。结果 14例胸部CD中10例为透明血管型（HVT），4例为浆细胞型（PCT）。HVT-CD均表现为边界清晰的均匀软组织密度影，其中2例周围见大小不等的淋巴结，2例伴有斑点样钙化，1例伴有粗糙样钙化，动态增强扫描示动脉期均呈明显强化，静脉期、延迟期持续强化。PCT-CD均见纵隔、双侧腋下肿大淋巴结影，伴有肺内间质性肺炎、肺内小结节、磨玻璃样密度影及胸腔积液，其中1例增强扫描呈持续性明显强化。结论 胸部HVT-CD CT平扫呈等密度影，动态增强呈明显持续性强化，可伴有卫星灶及钙化。具有以上影像表现的，应该考虑到HVT-CD。PCT-CD影像表现无特异性，需要结合临床资料综合评价，但明显强化的PCT-CD可以确诊。Objective To evaluate the imaging findings of thoracic Castleman＇s disease （CD） to improve the diagnostic accuracy. Methods The imaging findings of 14 cases of thoracic CD confirmed by pathology were analyzed retrospectively.Plain and dynamic contrast-enhanced CT scans were performed in all patients before surgery.Results Among the 14 cases, 10 cases were hyaline vascular type （HVT） and other 4 cases were plasma cell type （PCT）. HVT-CD showed well-define, homogeneous soft-tissue lesion with different sizes of lymph nodes around the lesions in 2 cases, mottled calcification in 2 cases and coarse calcification in 1 case. Dynamic enhanced CT showed HVT-CD had obvious enhancement in arterial phase,and sustained enhancement in venous phase and delayed phase.PCT-CD all showed enlarged lymph nodes in the mediastinum and bilateral axillary, associated with interstitial pneumonia, pulmonary nodules, ground glass opacity and pleural effusion, with marked and sustained enhancement 1 case.Conclusion Thoracic HVT-CD presents equal density on CT plain scan, and obvious and durative enhanement on multiphase contrast-enhanced CT, which can be accompanied by lymphnodes around the lesions and intratumoral calcification.With the above imaging findings,we should consider the possibility of HVT-CD.CT features of PCT-CD are non-specific, a comprehensive evaluation of the clinical data should be combined, but the obviously enhanced PCT-CD can be diagnosed.

关 键 词：胸部 CASTLEMAN病 计算机体层成像 

分 类 号：R551.2[医药卫生—血液循环系统疾病] R814.42[医药卫生—内科学]