原发性小肠淋巴瘤的不典型计算机断层扫描表现及分析  

Analysis of atypical computed tomography features of primary small intestinal lymphoma

作　　者：陈芳莹 赵雪松[1] 严嘉仪[1] 缪飞[1] Chen Fangying;Zhao Xuesong;Yan Jiayi;Miao Fei(Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China)

机构地区：[1]上海交通大学医学院附属瑞金医院放射科,200025

出　　处：《中华消化杂志》2019年第9期626-629,共4页Chinese Journal of Digestion

摘　　要：目的探讨原发性小肠淋巴瘤(PSIL)的不典型CT表现及其与病理表现的相关性。方法回顾性分析2007年7月至2018年6月在上海交通大学医学院附属瑞金医院经病理组织学证实具有不典型影像学表现的29例PSIL患者的临床和影像学资料。结果29例PSIL患者均为非霍奇金淋巴瘤,B细胞淋巴瘤23例,外周T细胞淋巴瘤6例。24例PSIL患者表现为不均匀肠壁增厚,5例表现为肠腔内外肿块。4例PSIL患者病灶CT平扫密度不均匀,5例CT增强扫描呈不均匀轻中度强化,5例于门静脉期可见明显强化,20例黏膜面有多发溃疡形成,5例可见黏膜面明显异常强化,13例病变肠壁浆膜层毛糙,周围脂肪间隙消失,4例邻近脏器受侵犯,8例伴发肠梗阻。结论PSIL影像学表现为病灶密度不均匀,CT增强扫描强化不均匀或明显强化,黏膜面多发溃疡形成,黏膜面异常明显强化,周围脂肪间隙模糊,邻近脏器受侵犯及伴发肠梗阻等不典型表现。Objective To investigate the atypical computed tomography (CT) features of primary small intestinal lymphoma (PSIL), and its correlation with pathology. Methods From July 2007 to June 2018, at Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, the clinical features and CT imaging data of 29 histopathologically diagnosed PSIL with atypical CT features were retrospectively analyzed. Results A total of 29 cases were all confirmed as Non-Hodgkin′s lymphoma including 23 cases of B cell lymphoma and six cases of peripheral T cell lymphoma. In 24 PSIL patients, the intestinal wall was unevenly thickened. While five cases had intra- and extra-intestinal masses. Images of four PSIL patients showed heterogeneous density at unenhanced CT scan, five cases presented with heterogeneous mild to moderate enhancement and five cases demonstrated with obvious enhancement at portal venous phase. Multiple ulcers in mucosa were found in 20 cases, and obviously abnormal mucosal enhancement was found in five cases, and 13 cases showed rough serosa layer of intestinal wall and the fat gap around the intestinal wall disappeared. Adjacent organs were involved in four cases and intestinal obstruction occurred in eight cases. Conclusion The atypical imaging of PSIL can be heterogeneous density of the lesion, heterogeneous or obvious enhancement at enhanced scan, multiple ulcers on the mucosal surface, thickening of the mucosal surface, blurred peripheral fat space, involvement of adjacent organs and intestinal obstruction.

关 键 词：原发性淋巴瘤 小肠 计算机断层扫描 

分 类 号：R735[医药卫生—肿瘤] R730[医药卫生—临床医学]