摘要
目的 回顾性分析55例胸腹部局限性Castleman病(LCD)的CT特征,并与病理学改变进行对照,研究对LCD有诊断价值的影像特点.方法 搜集20年间胸腹部LCD患者55例,其中胸部25例,腹部30例.55例均经手术切除和组织病理学证实.所有患者均行CT平扫和增强扫描,影像征象由2名放射学医师同时分析.结果 54例透明血管型(50例)和混合型(4例)Castleman病CT表现主要包括孤立性肿物(90.7%,49例)、边缘不规则或分叶或浸润(83.3%,45例)、中央性钙化(38.9%,21例)和显著强化(100%,54例),72.2%(39例)的病灶内可见局灶性非坏死性低密度影,70.4%(38例)和96.3%(52例)的病灶周围可见肿大的淋巴结和扩张的滋养血管.1例浆细胞型Castleman病表现为边缘不规则伴中央缺血坏死的轻度强化的单发肿块影.其CT分型包括边缘光整的单发肿块(4例)、边缘不规则或分叶状单发肿块(30例)、边缘模糊呈浸润性或磨玻璃样肿块(16例)及多发融合肿块(5例).结论 胸腹部LCD的CT表现与发生部位和病理类型密切相关,透明血管型和混合型的CT表现具有特征性,而浆细胞型LCD的CT表现则缺乏特征性.
Objective To assess the CT characteristics of thoracoabdominal localized Castleman disease (LCD) in 55 cases and correlate with histopathologic features. Methods Fifty-five patients with LCD proved histopathologically in thorax ( n = 25 ) and abdomen ( n = 30 ) were collected during past 20 years. The unenhanced and contrast-enhanced CT were performed in all patients. Two radiologists reviewed CT images and the CT findings were analyzed simultaneously. Results In 54 patients with hyaline-vascular type ( n = 50 ) and mixed type ( n = 4 ) localized CD, the lesion typically presented as solitary mass (90. 7% , 49 cases), with irregular or lobular or infiltrative margin ( 83.3% , 45 cases),central calcification (38. 9%, 21 cases), marked enhancement (100% , 54 cases), focal non-necrosis low attenuation areas (72. 2%, 39 cases), lymphadenopathy (70.4%, 38 cases) and dilated feeding vessels adjacent to the mass (96.3%, 52 cases). One lesion with plasma cell type localized CD presented as a mass with irregular margin, mild enhancement and central necrosis. Four morphologic patterns wereclassified on CT, including solitary mass with well-circumscribed margin (n =4), irregular or lobular margin ( n = 30), infiltrative or halo-like margin ( n = 16 ), and multiple coalescent maasses ( n = 5 ). Conclusion CT features of thoracoabdominal localized CD are closely related to the location and pathological type. LCD with hyaline-vascular and mixed type has typical CT characteristics, while LCD with plasma cell type has no typical CT findings.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2010年第11期1161-1166,共6页
Chinese Journal of Radiology