原发性睾丸淋巴瘤的CT及MRI诊断  

CT and MRI diagnosis of primary testicular lymphoma

作　　者：单康飞 李远 赵奋华 杨泽斌 傅春龙 SHAN Kangfei;LI Yuan;ZHAO Fenhua;YANG Zebin;FU Chunlong(Department of Radiology,Dongyang Hospital Affiliated to Wenzhou Medical University,Jinhua 322100)

机构地区：[1]温州医科大学附属东阳医院放射科,浙江金华322100

出　　处：《医学影像学杂志》2023年第12期2250-2252,共3页Journal of Medical Imaging

摘　　要：目的探讨原发性睾丸淋巴瘤(PTL)的CT和MRI表现。方法选取经手术证实的10例PTL患者的临床及影像资料,8例行CT增强检查,2例行MRI增强检查,分析其CT及MRI表现。结果肿瘤形态多呈椭圆形,平均直径5.6 cm×3.6 cm,左侧5例,右侧4例,1例先后双侧发生。CT平扫密度较均匀,增强扫描轻至中等程度强化,多数病灶内可见小血管穿行征。MRI表现为T_(1)WI呈等或稍低信号,T_(2)WI呈稍低信号,囊变坏死区呈稍高信号,DWI弥散呈高信号,ADC图呈低信号,增强扫描肿瘤多呈均匀中等程度强化,2例呈不均匀强化,见囊变无强化区。7例伴同侧精索静脉曲张,6例肿块边缘见鞘膜积液。结论老年男性发现睾丸无痛性肿块伴进行性增大,CT及MRI表现为密度(信号)均匀,增强扫描轻或中等程度强化,伴血管穿行征、周围鞘膜积液征、同侧附睾及精索受累征象时应考虑PTL的可能。Objective To investigate the CT and MRI findings of primary testicular lymphoma(PTL).Methods Clinical and imaging data of 10 patients with PTL confirmed by surgery were collected.8 patients underwent enhanced CT examination and 2 patients underwent enhanced MRI examination,and the CT and MRI findings were analyzed.Results Most of the tu⁃mors were oval in shape,with an average diameter of 5.6cm×3.6cm.There were 5 cases on the left side and 4 cases on the right side,and 1 case was bilateral successively.The density of plain CT scan was uniform,and the enhancement of CT scan was light to moderate,with small vessel crossing signs in most lesions.MRI showed equal or slightly low signal intensity on T_(1)WI,slightly low signal intensity on T_(2)WI,slightly high signal intensity on the necrotic area of cystic lesions,high signal intensity on DWI dif⁃fusion,and low signal intensity on ADC image.On enhancement scan,the tumor mostly showed uniform and moderate enhance⁃ment,and 2 cases showed uneven enhancement,without enhancement area of cystic lesions.7 cases were associated with ipsilat⁃eral varicocele and 6 cases had hydrocele at the edge of mass.Conclusion The possibility of PTL should be considered in el⁃derly men with testicular painless mass accompanied by progressive enlargement.CT and MRI showed uniform density(signal),mild or moderate enhancement on enhanced scan,accompanied by vascular traveling sign,peripheral hydrocele sign,ipsilateral epididymis and spermatic cord invasiveness.

关 键 词：原发性睾丸弥漫大B细胞淋巴瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R737.21[医药卫生—肿瘤] R445[医药卫生—临床医学]