四肢原发性骨淋巴瘤的临床及影像分析  

Clinical and imaging analysis of primary bone lymphoma of the extremities

作　　者：冯强强[1] 李新彤[1] 钱占华[1] 程晓光[1] 张薇[1] 宫丽华[2] 于爱红 FENG Qiang-qiang;LI Xin-tong;QIAN Zhan-hua;CHENG Xiao-guang;ZHANG Wei;GONG Li-hua;YU Ai-hong(Department of Radiology,Beijing Jishuitan Hospital,Beijing,100035,China)

机构地区：[1]北京积水潭医院放射科,100035 [2]北京积水潭医院病理科,100035 [3]首都医科大学附属北京安定医院放射科,北京100080

出　　处：《中国骨与关节杂志》2022年第3期169-173,共5页Chinese Journal of Bone and Joint

基　　金：北京市卫生系统高层次卫生技术人才培养项目(2009-02-03,2013-3-033)。

摘　　要：目的 分析四肢原发性骨淋巴瘤的临床及影像特点。方法 回顾性分析12例经病理证实的四肢原发性骨淋巴瘤临床和影像特点。结果 本组12例,男9例(75.0%),女3例(25.0%),年龄10~67岁,平均45.7岁。临床症状主要为局部疼痛。本组12例均为非霍奇金淋巴瘤,其中弥漫大B细胞淋巴瘤9例(75.0%)。单发病灶10例(83.3%),多发病灶2例(16.7%)。CT检查12例患者共14个病灶,溶骨型骨质破坏7个(50.0%),浸润型骨质破坏5个(35.7%),混合型骨质破坏2个(14.3%)。其中偏心性破坏7个病灶(50.0%),2个病灶存在“浮冰征”(16.7%),2个病灶有骨膜反应(16.7%),3个病灶(21.4%)存在病理性骨折。增强扫描病变轻中度不均匀强化。MRI检查3例患者,均在T_(1)WI呈等信号;T_(2)WI呈稍高信号1例,呈混杂信号2例。结论 “浮冰征”、偏心性骨质破坏以及大于骨质破坏范围的软组织肿块,对诊断四肢原发性骨淋巴瘤具有一定特征性。Objective To analyze the clinical and imaging characteristics of primary bone lymphoma of the extremities.Methods The clinical and imaging characteristics of 12 cases of primary bone lymphoma of the extremities were retrospectively analyzed.The diagnosis was confirmed by pathology.Results A total of 12 patients were analyzed,including 9 males (75.0%) and 3 females (25.0%) with an averaged age of 45.7 years (range:10-67 years).Local pain was the main symptom.All were non-Hodgkin’s lymphoma,including 9 cases of diffuse large B-cell lymphoma (75.0%).Single lesion was detected in 10 cases (83.3%),while multiple lesions were found in 2 cases.Fourteen lesions in 12 patients were detected by CT:7 osteolytic bone destruction (50.0%),5 infiltrating bone destruction (35.7%) and 2 mixed bone destruction (16.7%).Eccentrical destruction was noted in 7 lesions (50.0%),floating ice sign in 2 lesions (16.7%),periosteal reaction in 2 lesions (16.7%) and fracture in 3 lesions (21.4%).Three patients were examined by MRI,and isointensity on T_(1)WI was observed in all of them.Slight hyperintense on T_(2)WI was shown in 1 patient,and heterogeneous signal in 2 patients.Conclusions Floating ice sign,eccentrical destruction and soft-tissue mass that is much larger than cortical bone destruction are characteristics for the diagnosis of primary bone lymphoma of the extremities.

关 键 词：淋巴瘤 骨肿瘤 体层摄影术 X线计算机 

分 类 号：R738.1[医药卫生—肿瘤]