鼻部-韦氏环不同病理类型淋巴瘤影像学对照分析  

Imaging Comparison of Different Pathological Types of Lymphpma in the Nose and Waldeyer’s Ring

作　　者：崔杰 赵志新[2] 张加辉 朱修良[1] 余日胜[1] CUI Jie;ZHAO Zhixin;ZHANG Jiahui(Department of Radiology,the Second Affiliated Hospital of Zhejiang University Medical College,Hangzhou,Zhejiang Province 310000,P.R.China)

机构地区：[1]浙江大学医学院附属第二医院,杭州310000 [2]杭州市第三人民医院放射科,310000

出　　处：《临床放射学杂志》2020年第7期1291-1295,共5页Journal of Clinical Radiology

摘　　要：目的探讨鼻部-韦氏环不同病理类型淋巴瘤的影像学特点,提高诊断及鉴别诊断的准确性。方法回顾性分析病理证实的35例鼻部-韦氏环淋巴瘤的CT及MRI检查,结合病理分型并对照分析。结果35例患者,NK/T细胞淋巴瘤20例(57.1%),位于鼻部18例(90%)、韦氏环2例(10%),均为弥漫性病变,边缘显示模糊,CT平扫为低密度,MRI为稍长T1、长T2弛豫信号,均匀强化19例(95%),侵犯邻近骨质8例(40%),颈部淋巴结转移6例(30%);弥漫大B细胞淋巴瘤15例(42.9%),鼻部8例(53.%)、韦氏环7例(46.7%),其中局灶性肿块8例(53.3%)、边缘显示清晰,弥漫性病变7例(46.7%)、边缘显示模糊,CT平扫为等密度,MRI表现为等T1、稍长T2弛豫信号,均匀强化9例(60%),侵犯邻近骨质6例(40%),颈部淋巴结转移6例(40%)。经统计分析,NK/T细胞淋巴瘤较弥漫大B细胞淋巴瘤更好发于鼻部(P=0.021),多表现为弥漫性生长(P=0.001),边缘模糊(P<0.001)。两者的强化方式、邻近骨质破坏及颈部淋巴结转移情况无显著差异。结论CT及MRI检查有助于鼻部-韦氏环NK/T细胞淋巴瘤与弥漫大B细胞淋巴瘤的鉴别。Objective To discuss and analyze the imaging features of lymphoma involving the nose and Waldeyer’s ring based on different pathological types.Methods The CT scans and MRI images of 35 patients with pathologically confirmed NHL involving the nose and Waldeyer’s ring were retrospectively analyzed.Results In the 35 cases of NHL,NK/T cell lymphoma was found in 20 cases(57.1%),18 cases(90%)were located in the nose,and 2 cases(10%)were located in the Waldeyer’s ring.All were diffuse lesions with unclear edges.CT plain scan showed low-density shadows,while MRI showed slightly longer T1 and T2 signals.Uniform enhancement was demonstrated in 19 cases(95%);Invasion of adjacent bone was present in 8 cases(40%),cervical lymph node metastases in 6 cases(30%).Diffuse large B cell lymphoma was found in 15 cases(42.9%),8 cases(53.%)of the nose,and 7 cases(46.7%)of the Waldeyer’s ring.There were 8 cases of focal mass(53.3%)with clear edge,and 7 cases of diffuse lesions(46.7%)with ill-defined edges.CT plain scan showed iso-density,whereas MRI showed equal T1 and slightly longer T2 signal.Uniform enhancement was seen in 9 cases(60%);Invasion of adjacent bone in 6 cases(40%);Cervical lymph node metastases was found in 6 cases(40%).According to statistical analysis,NK/T cell lymphoma was more likely to occur in the nose than diffuse large B cell lymphoma(P=0.021),with diffuse growth(P=0.001)and ill-defined edges(P<0.001).There was no significant difference between the two types of enhancement,adjacent bone destruction and cervical lymph node metastasis.Conclusion CT and MRI examination can help distinguish NK/T cell lymphoma from diffuse large B cell lymphoma in the nose and waldeyer’s ring.

关 键 词：鼻部与韦氏环 非霍奇金淋巴瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.62[医药卫生—肿瘤]