腹部Castleman’s病的多层螺旋CT表现

Findings of MSCT in Castleman's disease of the abdomen

目的:分析Castleman’s病的多层螺旋CT(MSCT)表现,提高对其认识。方法:回顾性分析9例经手术病理证实的Castleman’s病患者的MSCT表现,总结其MSCT特征。结果:9例中5例位于腹盆腔,4例位于腹膜后。9例中局限型8例,弥漫型1例。局限型7例病理诊断均为透明血管型,CT平扫与肌肉相比呈等密度;动态增强CT扫描,多数肿块动脉期明显强化,在延迟期均表现为持续强化,强化程度接近大动脉。局限型和弥漫型各1例为浆细胞型,表现为腹膜后多个软组织结节,轮廓光整,轻度强化。结论:淋巴结增生症的CT表现与组织病理学密切相关,局限透明血管型Castleman’s病MSCT表现具有一定特征性;弥漫浆细胞型Castleman’s病无特征性影像学表现,确诊依赖组织病理学。

Objective： To analyse the most suggestive multi-slice CT （MSCT） imaging findings of Castleman＇s disease, and to improve the recognition of this disease. Methods： MSCT imaging materials of nine patients with Castleman＇s disease were retrospectively reviewed, diagnosis of Castleman＇s disease was done by surgery and pathology. Results： Nine lesions were located in the abdomen and pelvis（n=5） and the retroperitoneal zone（n=4） respectively. The lesions were localized in 8 cases and disseminated in 1 case. Seven cases were hyaline vascular type of Castleman＇s disease, on plain CT images, the lesions manifested as homogeneous soft masses, which was isoattenuating to muscle. On dynamic contrast CT scan, most of the masses show marked enhancement at arterial phase and delayed scan and the attenuation was similar to that of aorta. The pathologic subtype of 2 localized and disseminated cases was plasma cell type. Imaging findings showed several well-defined nodules lied in the retroperitoneal zone and enhanced lightly. Conclusion： CT findings of Castleman＇s disease are closely associated with its pathyology. For localized type（hyaline vascular type） of Castleman＇s disease have typical MSCT signs. For disseminated type （plasma cell type） carries no specific CT signs, its verification is mainly based on pathologic examination.