原发性结外淋巴瘤的影像诊断及共性特征分析  

Imaging diagnosis and common characteristics analysis of primary extranodal lymphoma

作　　者：周泽旺[1] 冷西 李巧[1] 张昌政[1] ZHOU Zewang;LENG Xi;LI Qiao;ZHANG Changzheng(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangdong Guangzhou 510405,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《现代肿瘤医学》2022年第6期1085-1088,共4页Journal of Modern Oncology

基　　金：广东省自然科学基金项目(编号:2018A030310621);广东省中医药局科研项目(编号:20181089)。

摘　　要：目的:探讨原发性结外淋巴瘤(primary extranodal lymphoma,PENL)的共性影像学特征,提高其诊断水平。方法:回顾性分析经病理证实的38例PENL患者的CT及MRI影像资料。结果:38例PENL病例中,发生于头颈部13例,胃肠道10例,骨骼7例,胸部5例,泌尿系3例。20例行CT检查,11例行MRI检查,7例同时行CT和MRI检查。27例CT影像中17例(63%)肿瘤发病部位固有解剖结构存留,21例(78%)肿瘤密度及强化均匀,22例(81%)增强呈轻-中度强化。18例MRI影像中11例(61%)发病部位固有解剖结构存留,13例(72%)肿瘤信号及强化均匀,12例(67%)增强呈轻-中度强化,10例(56%)肿瘤T2WI信号呈等或稍低信号,8例行DWI检查均表现为弥散受限高信号。38例PENL病例中,10例CT或MRI影像可见自相矛盾现象,5例可见“血管漂浮征”,2例见“骨皮质开窗征”。结论:原发性结外淋巴瘤的CT及MRI表现具有一定的共性特征,这些特征有助于提高诊断准确性及鉴别诊断。Objective:To explore the common imaging features of primary extranodal lymphoma(PENL)and improve its diagnostic level.Methods:The CT and MRI imaging manifestations of 38 PENL patients confirmed by pathology were analyzed retrospectively.Results:Among 38 PENL cases,13 cases occurred in the head and neck,10 cases in the gastrointestinal tract,7 cases in the bones,5 cases in the chest,and 3 cases in the urinary system.Twenty cases underwent CT examinations,11 cases underwent MRI examinations,and 7 cases underwent both CT and MRI examinations.Among the 27 cases of CT images,17 cases(63%)had the inherent anatomical structure at the tumor site,21 cases(78%)had uniform tumor density and enhancement,and 22 cases(81%)had enhanced mild to moderate enhancement.In 18 cases of MRI images,11 cases(61%)had inherent anatomical structures,13 cases(72%)had uniform tumor signal and enhancement,12 cases(67%)showed mild to moderate enhancement,10 cases(56%)of tumors showed equal or slightly low signal on T2WI,and 8 cases of DWI showed limited diffusion.Among 38 PENL cases,10 cases showed self-contradiction in CT or MRI images,5 cases showed"vascular floating sign",and 2 cases showed"cortical bone fenestration sign".Conclusion:The CT and MRI manifestations of primary extranodal lymphoma have certain common features,which are helpful to improve the diagnostic accuracy and differential diagnosis.

关 键 词：淋巴瘤 结外 X线计算机 磁共振成像 

分 类 号：R733.4[医药卫生—肿瘤]