原发性脾脏淋巴瘤的CT、MR影像学表现和病理对照分析  

Comparative Analysis of CT and MR Imaging Findings and Patholog y of Primary Splenic Lymphoma

作　　者：杨婉 刘松[1] 李琳[2] 施桦 YANG Wan;LIU Song;LI Lin;SHI Hua(Department of Medical Imaging,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China;Department of Pathology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,,Nanjing 210008,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,江苏南京210008 [2]南京大学医学院附属鼓楼医院病理科,江苏南京210008

出　　处：《中国CT和MRI杂志》2025年第4期132-135,共4页Chinese Journal of CT and MRI

摘　　要：目的总结原发性脾脏淋巴瘤(primar y splenic lymphoma,PSL)的影像学表现、病理特征,探讨不同类型PSL影像表现的潜在病理机制。方法回顾性分析25例PSL临床、影像学表现,并与病理进行对照分析。结果25例PSL中均匀弥漫型15例,粟粒结节型3例,单发肿块型3例,多发肿块型4例。22例可见脾脏肿大。10例可见病灶,CT增强扫描3例病灶无明显强化,4例轻度强化,2例中度强化;4例病灶出现坏死。脾脏边缘区淋巴瘤(splenic marginal zone lymphoma,SMZL)12例均出现脾大,其中均匀弥漫型10例,粟粒结节型2例;弥漫大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)6例,均匀弥漫型1例,肿块型5例。结论PSL影像学表现具有特征性,且与组织病理学分型密切相关。SMZL多表现为均匀弥漫型,常伴脾脏肿大;DLBCL多表现为肿块型,可见坏死和病灶轻度强化。术前PSL影像表现对区分PSL亚型有诊断价值。Objective To summarize the imaging manifestations as well as the pathological characteristics of primary splenic lymphoma(PSL),and to explore the potential pathological mechanisms responsible for different types of PSL imaging manifestations.Methods The clinical and imaging manifestations of 25 cases of PSL were retrospectively analyzed and compared with pathology.Results Among the 25 cases of PSL,there were 15 cases of homogeneous diffuse type,3 cases of miliary nodular type,3 cases of single mass type,and 4 cases of multiple mass type.Splenomegaly was seen in 22 cases.Lesions were visible in 10 cases.On enhanced CT scan,3 cases had no obvious enhancement,4 cases had mild enhancement,2 cases had moderate enhancement;necrosis occurred in 4 cases.Splenic marginal zone lymphoma(SMZL)showed splenomegaly in all 12 cases,including 10 cases of homogeneous diffuse type and 2 cases of miliary nodular type.There were 6 cases of diffuse large B-cell lymphoma(DLBCL),including homogeneous diffuse type in 1 cases and mass type in 5 cases.Conclusion The imaging manifestations of PSL are characteristic and closely related to histopathological classification.SMZL mostly presented as homogeneous diffuse type,often accompanied by splenomegaly;DLBCL usually presented as mass type,with necrosis and mild enhancement of the lesions.Preoperative PSL imaging findings have diagnostic value in distinguishing PSL subtypes.

关 键 词：原发性脾脏淋巴瘤 体层摄影术 X线计算机 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]