巨淋巴结增生的CT、MRI表现

CT and MRI appearances of giant lymph node hyperplasia

目的研究经病理学检查证实的巨淋巴结增生(CD)的CT及MRI的影像特征,以期提高正确诊断率。方法回顾性分析9例巨淋巴结增生病例的CT及MRI表现,并与手术病理学检查结果对照,总结其CT及MRI表现特征。结果9例病变分布为颈部1例、胸壁1例、纵隔5例、腹部2例,其中,局限性8例。CT表现为中等密度、动脉期明显强化、静脉期及延迟期持续强化。3例行MRI检查,表现为平扫呈等T1长T2,动脉期病变明显强化,静脉期及延迟期呈持续强化及边缘环形强化;增强扫描病变周围可见迂曲血管影。6例透明血管型病变周围可见多个反应性淋巴结增生;浆细胞1例,纵隔内多发淋巴结肿大,腋窝淋巴结肿大,增强扫描呈中等度强化。结论透明血管型CD的CT及MRI有明显的特征性,并且MRI优于CT。浆细胞型CD病变无特征性影像表现。

Objective To analyze CT and MRI appearances of Castleman Disease （CD） ,and improve its recognition. Methods Retrospectively reviewed CT and MRI appearance of 9 cases of Castleman Disease which were pathologically proved through operation and concluded their characteristics. Results Among 9 cases,1 case was located in the neck, 1 in chest wall,5 in mediastinum, and 2 in abdomen. 8 cases of all were limited type. CT showed intermediate density. The masses were obviously enhanced in dynamic enhancement, and were continuously enhanced in venous and delay phase. In 3 cases, MRI showed iso-T1 and long T2 signal in non- enhancement. In arterial phase,they were obviously enhanced,and were continuously enhanced in venous and delay phase. All of 3 cases showed ring enhancement in the border and circuitous vascular images which were seen around the lesions in the enhancement phase. In 6 cases of hyaline vascular type, several responsive hyperplasia of lymph node around the lesions were seen： Plasmacyte type was in 1 case,several enlarged lymph nodes in mediastinum and axillary fossa and showed intermediate enhancement. Conclusion Hyaline vascular type of CD has obvious characteristics and MRI is superior to CT. Plasmacyte type of CD has no characteristic imaging findings.