卵巢淋巴瘤的CT、MRI表现

CT and MRI Diagnosis of Non-Hodgkin Lymphomas in the Ovaries

目的提高对卵巢淋巴瘤的CT、MRI表现的认识。资料与方法回顾性分析经病理证实的卵巢淋巴瘤5例,3例CT检查(其中1例平扫加增强,2例直接增强扫描);2例MRI检查(平扫加增强)。结果(1)4例B细胞性非霍奇金淋巴瘤(NHL)(其中1例为Burkitt淋巴瘤),1例外周T细胞性NHL。(2)5例中未见原发性卵巢淋巴瘤。(3)盆腔双侧肿块3例,单侧肿块1例,多发肿块1例。最大直径4.5～17cm,平均7.4cm。5例中4例边缘清晰,圆形或卵圆形各1例,分叶状2例;1例边缘欠清,分叶状,与周围组织略见粘连。(4)CT表现:平扫1例病灶为等密度,未见钙化;增强扫描1例均匀强化,2例轻至中度强化伴少许斑片状低密度影。(5)MRI表现:2例T1WI为均匀低信号,T2WI为均匀稍高信号;增强后1例轻度均匀强化,1例边缘不规则中度环形强化。(6)5例中3例伴大网膜、肠系膜、腹膜后及盆腔淋巴结肿大。结论当盆腔存在双侧肿块,均质结构,无明显坏死,无明显强化,伴肠系膜、腹膜后、盆腔等部位淋巴结肿大,提示卵巢淋巴瘤可能。

Objective To discuss CT and MR findings of ovarian non-Hodgkin lymphoma （NHL） and improve the recognition of this disease. Materials and Methods The CT and MRI data of 5 cases with pathologically proven NHL of the ovaries were analyzed retrospectively. 3 cases underwent CT examination （1 case with pre-post contrast scan, 2 cases with post contrast scan directly）. 2 cases underwent MRI examination （pre-post contrast scan）. Results （1） 4 cases were B-cell NHL （1 case with Burkitt NHL）, 1 case was T-cell NHL. （2） No case showed a primary involvement of the ovaries. （3）Among the 5 cases, we found bilateral lesions in 3, unilateral in 1, multiple in 1. The size from 4.5 cm to 17 cm, the mean size of the lesions was 7.4 cm, The 4 of 5 cases had well defined margins and were primarily round and oval for each and lobulated for two, another case had insufficient defined margin and a little invasion of neighboring structures. （4） Plain CT showed the mass with isodensity without calcification. On post-contrast CT images, 1 case showed homogeneously enhancement, 2 cases showed mild to moderate contrast enhancement with little patching low density. （5） 2 cases showed homogeneously hypointensity signal on T1-weighted image and hyper intensity signal on T2W, 1 case showed slight homogeneous enhancement and the other case showed moderate heterogeneons enhancement with margin irregular enhancement. （6） 3 cases had lymphadenectasis in omentum, mesentery, retroperitoneum. Condusion The diagnosis of ovarian lymphoma should be considered in the presence of bilateral solid ovarian masses with homogeneous pattern without obviously necrosis and contrast enhancement, accompanied with lymphadenctasis of colic omenturn, mesentery, retroperitoneum.