CT误诊为淋巴瘤的纵隔肿物分析

Analysis the Misdiagnosis of Mediastinal Mass as lymphoma with CT

目的分析纵隔内肿块性病变易误诊为淋巴瘤的主要原因,探讨纵隔病变的CT鉴别诊断要点。资料与方法回顾性分析20例CT误诊为纵隔淋巴瘤,后经手术病理或穿刺活检证实为其他病变的纵隔肿物,分析其临床及CT表现与淋巴瘤的鉴别点。结果20例误诊病例的最终结果分别为:淋巴结结核6例,组织坏死性淋巴结炎2例,艾滋病(AIDS)淋巴结肿大2例,淋巴结转移癌4例,结节病3例,食管癌2例,支气管源性囊肿1例。均表现为纵隔肿块和/或淋巴结肿大,但在病变位置和病变特点上有所不同。结论纵隔肿块性病变的CT诊断须将病变位置、病变特点与临床资料相结合,才能减少误诊,提高诊断准确率。

Objective To analyze the reason of misdiagnosis of mediastinal mass lesions as lymphoma, and to explore the CT features in differential diagnosis. Materials and Methods 20 cases of mediastinal mass, which were misdiagnosod as lymphomas were analyzed retrospectively, their differentiate points of clinic and CT features from lymphomas were analyzed. Results The final pathological diagnosis were as follows, tuberculosis lymphadentis （ n = 6）, necrosis of lymphadenopathy （ n = 2 ）, lymphadenopathy of MDS （ n = 2）, metastasis of mediastinal lymph nodes （ n = 4）, intrathoracic sareoidosis （ n = 3）, esophageal carcinoma （ n = 2） and branchocyst （ n = 1 ）. Their common manifestations were mediastianal mass or lymphadenopathy, but the regions and patterns of lesions were different. Conclusion Combined the clinical manifestations with the regions and patterns of mediastinal mass, the diagnosis could be made more correctly.