颈部组织细胞性坏死性淋巴结炎的CT表现

CT findings of histocyticnecrotizing lymphadenitis in the neck

目的分析颈部组织细胞性坏死性淋巴结炎的CT表现，提高对其的认识水平。方法回顾性分析经临床手术及病理证实的颈部组织细胞性坏死性淋巴结炎10例患者的CT资料，男7例，女3例，年龄4～75岁，中位年龄26岁，9例行颈部CT平扫，其中5例同时行颈部增强扫描，1例直接行颈部增强扫描。结果10例均表现为颈部淋巴结受累，共检出受累淋巴结127枚，以II～V区为主。受累淋巴结长径0．5～3．6cm，平均1．3cm。CT平扫示受累淋巴结密度均匀者108枚，不均匀者8枚，CT增强扫描示受累淋巴结均匀强化79枚，不均匀强化27枚，110枚受累淋巴结边缘不清，周围脂肪间隙模糊。结论颈部组织细胞性坏死性淋巴结炎CT表现多样，缺乏特异性，需与其他淋巴结病变相鉴别，结合临床表现及实验室检查有利于诊断与鉴别诊断。

Objective To investigate the CT findings of histocyticnecrotizing lymphadenitis （HNL） in the neck. Methods CT data of 10 patients with pathologically confirmed HNL in the neck were retrospectively analyzed, 7 males and 3 females, aged from 4 to 75 years old （median age 26 years old）. Nine patients had plain CT scans and 5 of them had contrast scans. One case had only contrast CT scan. Results Totally, 127 lymph nodes were identified in the neck, mainly located in the area of II , III, IV and V. The maximum diameter of the involved lymph nodes ranged from 0. 5--3.6 cm, 1.3 cm in average. One hundred and eight lymph nodes were homogeneous and 8 were heterogeneous in plain CT images. Seventy nine lymph nodes had homogeneous enhancement and 27 had heterogeneous enhancement. One hundred and ten lymph nodes had unclear margins and the surrounding fat was blurred. Conclusion CT findings of HNL of the neck are variable and non-specific. Clinical findings and laboratory examination may be helpful for the diagnosis and differential diagnosis.