头颈部非霍奇金淋巴瘤的CT表现

CT findings of non Hodgkin lymphoma in the head and neck

目的 评价头颈部非霍奇金淋巴瘤(nonHodgkinlymphoma,NHL)的CT表现特点,为临床诊疗提供可靠依据。方法 将36例NHL病灶分为颈淋巴结内组和淋巴结外组,并观察其CT形态、密度和边缘。结果 结外NHL病变共39灶(31例),依次见于Waldeyer环(11灶)、上颌(8灶)、颌面间隙(7灶)、腮腺(6灶)和头颈其他部(7灶)。病变形态有肿块和粘膜异常增厚之分。结内NHL病变共累及16侧颈区淋巴结。结外NHL伴结内NHL者共10侧颈区。结论 头颈部结外NHL的CT表现特点为多发边缘不光滑的软组织实性肿块;颈淋巴结内NHL多有坏死和边缘增强。

Objective To evaluate the characteristic CT findings of non Hodgkin lymphoma (NHL) in head and neck. Methods Thirty six patients with the head and neck NHL consisted of 23 males and 13 females, median 49.2 years. All cases were categorized into two groups: extranodal and nodal NHL lesions. Results The extranodal NHL disease included 39 lesions (31 cases), and, the frequent head and neck sites of such lesions were Waldeyer's ring ( n =11), maxilla ( n = 8), maxillofacial spaces ( n =7), salivery gland ( n =6), and others ( n = 7). 30 lesions were soft tissue mass; 9 were mucosal thickening abnormality (including Waldeyer's ring in 6 lesions, maxilla in 2 lesions, and nasal cavity in one lesion). The majority of such extranodal NHL diseases were demonstrated on CT as non necrosis (33 lesions) and uneven margin (26 lesions). Sixteen lymph node NHL lesions were composed of 6 NHL confined to neck lymph nodes and 10 combinations of nodal and extranodal NHL diseases. 5/6 of the former had the condition with rim enhancement, necrosis and confluent nodal mass. Of ten of the latter, 7 had the necrostic lesion with rim enhancement, and 3 had the lesion with confluent nodal mass. Conclusion Multiple maxillofacial extranodal sites of soft tissue mass with the presence of non necrosis and uneven margin should be considered as the characteristic sign of NHL disease in the head and neck. Most nodal NHL may have the lesion with necrosis and rim enhancement, and the confluent mass is commonly seen in NHL confined to the neck lymph nodes.