原发性结肠恶性淋巴瘤的X线及CT诊断

X-ray and CT diagnosis of primary colic malignant lymphoma

目的:探讨结肠恶性淋巴瘤的临床X线和CT表现,以提高其诊断能力。方法:回顾性分析30例经病理证实的结肠淋巴瘤的X线钡灌肠及CT表现,钡灌肠观察病变发生部位、范围、黏膜破坏及肠管有无扩张或狭窄,CT观察结肠受累的部位、病灶大体形态、侵犯范围、肠壁厚度、浆膜及周围脂肪间隙受累情况、增强后强化程度、有无坏死、有无其他器官受累、肠旁及其他腹部淋巴结情况。结果:X线表现为多结节状充盈缺损伴肠管狭窄7例,肠管移位伴肠管边缘不整2例,肠管狭窄伴肠套叠2例,肠管狭窄伴不全梗阻2例,管状狭窄伴充盈缺损5例。CT表现为局灶性肿块型4例,节段环形浸润型10例,弥漫浸润型3例。结论:原发性结肠恶性淋巴瘤的X线及CT表现有一定特征性。

Objective：To analyse the chnical manifestations of X-ray and CT of primary colic malignant lymphoma,so as to improve the diagnostic ability.Methods：The clinical manifestations of X-ray barium enema and CT in 30 patients with primary colic malignant lymphoma confirmed by pathology were analysed retrospectively.The barium enema was used to observe the site and sphere of pathologic change and the condition of mucosal destruction as well as the intestinal canal was dilated or narrowed or not,while CT was used to observe the involved site of the colon,gross appearance of the foci,aggressive sphere,intestinal wall thickness,the potentiated degree after enhancement,the involved condition of serous membrance and peripheral fatty space and the condition of perienteric and other abdominal lymph nodes as well as there was necrosis or other organ involvement or not.Results：X-ray and CT displayed the different imaging features in primary colic malignant lymphoma.In this group,10 cases were regional annular infdtrative type,7 cases were polynodular Idling defect with intestinal stenosis,5 tubular stenosis with Idling defect,4 focal lump type,3 diffuse infiltrative type and 2 each for intestinal displacement with intestinal marginal irregularity,intestinal stenosis with intussusception and intestinal stenosis with incomplete obstruction.Conclusion：Mastering the X-ray and CT imaging features of primary colic malignant lymphoma may improve the differential diagnosis which is useful in clinical decision.