纵隔巨淋巴结增生影像学表现

The imaging findings of giant lymph node hyperplasia in mediastinum

目的探讨纵隔巨淋巴结增生的临床、病理、影像学表现之间的关系。方法对5例经手术病理证实的纵隔巨淋巴结增生的胸片、CT、MRI等检查与临床病理资料进行回顾性分析。结果本组5例中4例误诊,其中2例误诊为神经源性肿瘤,1例误诊为支气管淋巴结核,1例误诊为胸腺瘤,1例确诊。2例位于左中下纵隔,半弧形;1例位于左后上纵隔,蚕豆形;2例位于右中上纵隔,为类圆形,分叶;边缘均光滑。3例肿块内有钙化影;CT增强扫描3例呈中等密度均匀强化,1例呈均匀明显强化。病理结果:4例属浆细胞型,1例属血管型。结论纵隔巨淋巴结增生影像学有一定的特征性,结合临床症状,可以提示该病可能,确诊常赖于手术和病理。

Objective A comparative study of the clinical, pathological, imaging diagnosis of giant lymph node hyperplasia in mediastinum. Method The chest film, CT, MRI images and surgical pathology of five patients with giant lymph node hyperplasia of the mediastinum were retrospectively analyzed. Results Only one patient out of five was accurately diagnosed preoperatively, and the rest four cases were misdiagnosed as neurogenic tumors in 2 cases, as the bronchial tuberculosis in one case, and as thymoma in another case. Lesions were located in left middle and lower compartment of the mediastinum in 2 cases, semi - curved in shape; in left upper and posterior compartment in 1, resembling a broad bean in shape; and located in right middle and upper compartment in 2, round and lobulated. The edge of the lesions was smooth. The calciiication were identified in 3 cases. On the contrast-enhanced scan, moderate homogeneous enhancement was seen in 3cases, and remarkable homogeneous cohancement was displayed in 1. Pathology showed plasma cell type in 4 cases, and hyaline vascular type in the rest 1. Conclusions Giant lymph node hyperplasia in mediastinum may be suspected with characteristic imaging findings and clinical manifestations, while the diagnosis usually confirmed by operation and pathology.