成人重症肌无力中胸腺淋巴样滤泡性增生的CT表现

CT findings of lymphofollicular thymic hyperplasia in adult myasthenia gravis

目的认识成人重症肌无力(MG)中胸腺淋巴样滤泡性增生的CT表现。方法复习134例经手术、病理确诊为胸腺淋巴样滤泡性增生的MG患者胸腺区的CT表现,并与165例正常人作了比较和统计学处理。结果病例组中有31例胸腺增大、5例直径＜3 cm的结节,共36例(26．9%)可在CT上确诊；9例(6．7%)呈形态正常但未增大的软组织密度胸腺、2例(1．5%)有＞3 cm的肿块被认为该病的可能性很大；其余病例在胸腺区内都有密集度不一的斑点、索条影；无一例胸腺区完全为脂肪取代。上述表现除斑片、索条影外,其余与正常对照组比较差异均有统计学意义(P＜0．01)。结论CT是在成人MG病例中诊断胸腺淋巴样滤泡性增生的重要方法。

Objective To evaluate the CT findings of lymphofollicular thymic hyperplasia in adult myasthenia gravis （MG）. Methods The CT findings of thymus area of 134 adult patients with lymphofollicular thymic hyperplasia in MG were reviewed, all of them with surgically and histologically proven diagnosis, and compared with the CT findings of 165 normal subjects. Results In the group of patient, CT showed enlargement of thymus in 31 patients,5 patients had nodule or mass（ 〈 3 cm） ;thus 36 cases（26. 9% ） can confirmed diagnose by CT with thymic hyperplasia. CT showed 2 masses（ 〉 3 cm） and 9 patients（6. 7% ） had normal size thymus with soft-tissue density, it can considered with thymic hyperplasia. The spotty or streak shadow showed in other patients, though it could not be certain diagnosed as thymic hyperplasia, but could not be except it. The thymus area tissue complete replacement by fatty density were not found in patient group. The CT findings of patients had marked difference when compared with group of normal subjects（ P 〈0. 01 ）, except the spotty or streak shadows. Conclusion CT scan is an important method in diagnosing thymic lymphofollicular hyperplasia of MG in adult.