纵隔恶性淋巴瘤的CT表现

CT Manifestations of Malignant Mediastinal Lymphoma

目的:分析纵隔恶性淋巴瘤的CT表现,提高对其影像学表现的认识。方法:回顾分析经手术或穿刺病理证实的18例恶性淋巴瘤病例的CT表现。扫描用Philips,Mx8000,4排螺旋CT,包括CT平扫和增强。结果:18例中霍奇金病(HD)6例,非霍奇金病(NHL)12例。纵隔肿块表现为多结节融合型15例,其中3例病灶内见小片坏死。表现为分散结节型3例。伴发胸腔积液11例,其中3例为双侧性积液,伴心包增厚积液3例,肋骨、胸壁侵犯2例,肺部同时受累2例。18例病灶内均无钙化。病灶轻、中度强化,强化值10～46 HU。结论:纵隔恶性淋巴瘤影像学表现有其一定特异性,一般为多组淋巴结同时受累,多结节融合型多见,平扫和增强后密度基本均匀,钙化少见,HD常累及血管前组淋巴结。增强后轻至中度强化。

Objective：To review the CT manifestations of malignant mediastinal lymphoma and improve the understanding of its imaging performance. Methods： Retrospective analysis of the CT manifestations of 18 malignant mediastinal lymphoma cases which were confirmed by surgery and or biopsy. Plain and enhanced scans were done with 4 detector-row CT. Results： In six of 18 cases with Hodgkin＇s disease （HD） and twelve with non-Hodgkin＇s disease （NHL）, fifteen cases have multiple nodules including three cases with flake necrosis in center; three cases have appearance of scattered nodules. Eleven cases were associated with pleural effusion including three cases of bilateral effusion and three with pericardial thickening. Two cases were of rib chest wall invasion and two of pulmonary involvement. All 18 cases have no calcification. The lesions have slight to moderate enhancing ranged from 10 to 46 HU. Conclusion： The manifestations of malignant mediastinal lymphoma has its specific appearances with multi-lymph nodes involvement and multinodular fusion. CT appearance has uniform density in plain and enhanced scans and with little calcification. HD often involved the lymph nodes in pre-vascular space. The lesions have slight to moderate enhancement.