Castleman病多系统病变的CT表现  

CT findings of multisystemic lesions in Castleman disease

作　　者：强军[1] 陈殿森[1] 段晓培 QIANG Jun;CHEN Diansen;DUAN Xiaopei(Department of Radiology,The First Affiliated Hospital,College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院影像科,河南洛阳471003

出　　处：《医学影像学杂志》2022年第4期672-675,共4页Journal of Medical Imaging

基　　金：河南省高等学校重点科研项目计划项目(编号:19A320022)。

摘　　要：目的分析Castleman病(CD)多系统病变的CT表现特征,提高对本病各系统受累的影像学认识。方法选取31例经病理确诊为Castleman病的CT图像资料,其中单中心型(UCD)17例,均为透明血管型(HV);多中心型(MCD)14例,均为浆细胞型(PC)。结果17例UCD位于颈部3例,胸部9例,腹部5例,CT表现为单发均质或主体均质等密度类圆形肿物,14例增强后肿物呈均质或主体均质明显强化。4例出现结外器官肺异常,3例表现为肺内小结节影,1例呼吸气相HRCT两肺表现为闭塞性细支气管炎。14例MCD均可见全身多发淋巴结肿大,11例增强扫描显示肿大淋巴结均质强化;其中淋巴结轻度强化7例,中度和明显强化各2例。14例MCD中,12例出现结外器官组织异常,其中8例出现肺部异常,7例肝脾肿大,4例出现浆膜腔积液;肺部异常表现为两肺小叶中心分布小结节影8例,1~2 cm大结节影2例;其他征象包括:磨玻璃密度影、小叶间隔增厚和索条影各4例,斑片状实变3例,囊腔2例,血管支气管束增粗1例。结论CD除了淋巴结外,还累及结外器官,具体CT表现与CD的病理分型有关。Objective To explore CT manifestations of multiple systemic lesions in Castleman disease(CD),and to improve the imaging knowledge of various systems involved in the disease.Methods The CT image data of 31 cases of CD diagnosed by pathology were analyzed retrospectively.Among them,there were 17 cases of unicentric CD(UCD),all of which were hyaline vascular type(HV)and 14 cases of multicentric CD(MCD),all of which were plasma cell type(PC).Results Seventeen cases of UCD were located in 3 of neck,9 of chest and 5 of abdomen.CT manifested round masses of homogeneous density,which had homogeneous and obvious enhancement after enhanced scan.Four cases demonstrated pulmonary abnormality of external lymph node.Three cases showed multiple small nodules.One case showed pulmonary manifestations as bronchiolitis obliterans in respiratory phase HRCT.All 14 cases of MCD showed multiple lymph node enlargement in the whole body.Enhanced scan manifested homogeneous enhancement of enlarged lymph nodes in 11 cases,of which 7 cases were mild enhancement,2 moderate and 2 obvious.Abnormalities of organ tissue outside the lymph nodes were found in 12 cases,including 8 cases with pulmonary abnormality,7 with hepatosplenomegaly and 4 with serous cavity effusion.Pulmonary abnormality showed small centrilobular nodules in all 8 cases,and other signs were such as 1.5 cm large nodules in 2,ground glass opacity in 4,interlobular septal thickening in 4,streaks in 4,patchy consolidation in 3,cysts in 2 and Vascular bronchial bundle thickening in 1.Conclusion In addition to the lymph nodes,CD also involves the external lymph node organs,and the specific CT manifestations are related to the pathological types of CD.

关 键 词：巨淋巴结增生 淋巴结 肺 体层摄影术 X线计算机 

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]