Castleman病的CT表现与病理对照

Comparision between CT Appearances and Pathology of Castleman’s Disease

目的:提高对Castleman病CT表现的认识。材料和方法:回顾性分析10例经手术证实为Castleman病的CT表现。结果:纵隔4例、肠系膜1例和腹膜后5例。临床类型为局灶型7例和多中心型3例。病理分型为透明血管型7例和浆细胞型3例。透明血管型CT平扫表现为密度均匀,但中间可有条状或裂隙样低密度,而增强扫描表现为除条状或裂隙样低密度外,明显均匀增强,并与腹主动脉同步增强,周围可有点条状增强血管;浆细胞型CT平扫表现为密度均匀,而增强扫描表现为轻中度均匀增强。结论:CT表现与临床类型、病理分型关系密切,透明血管型的CT表现比较有特征,浆细胞型缺乏特征性,诊断需要密切结合临床病史和实验室检查。

Purpose ： To improve the recognition of imaging features of Castleman＇ s disease. Materials and Methods： The CT manifestations of 10 cases with Castleman＇ s desease proved by operation were Analysed retrospectively. Results： There were 4 cases in mediastinum,1 case in mesentery and 5 case in retroperitoneum ;There were focal type in 7 cases while diffuse type in 3 case clinically; There were hyaline-vascular type in 7 cases and plasma type in 3 cases pathologically . The hyaline-vascular type lesion appeared as a homogeneously hyperdense mass with central stripe or cleft hypodense area on CT plain scans, but was markedly enhanced simultaneously with abdominal aorta enhanced except the stripe or cleft area , or with some stripe or spot enhanced vessels around it ; The plasma type lesion appeared as a homogeneously hyperdense mass on plain CT scans with mildly or moderately enhanced on enhanced CT scans. Conclusions： The relationship between the CT appearances and pathological and clinical types of Casfleman＇ s Disease is very close. The hyaline-vascular type lesion has some characteristic manifestations on CT , but the plasma type one has not any characteristic, so it must be combined with clinic to diagnosis.