摘要
目的:探讨非霍奇金淋巴瘤深部淋巴结受累以及大血管侵犯的CT表现特征。方法:搜集经手术或穿刺病理证实为淋巴瘤患者101例,其中62例有深部淋巴结受累符合入组条件,按照病理类型归类分为弥漫大B细胞淋巴瘤38例,外周T细胞淋巴瘤13例,滤泡性淋巴瘤、小B细胞淋巴瘤、套细胞淋巴瘤各3例,小淋巴细胞性淋巴瘤2例。所有患者均行多层螺旋CT增强扫描,对其CT图像资料进行回顾性分析。结果:①分布部位:几乎所有的病理类型均以腹膜后及腹腔淋巴结受累为主。并可以同时有纵隔及盆腔淋巴结受累;②淋巴结孤立与融合:按照不同的病理类型及部位,弥漫大B细胞淋巴瘤、套细胞淋巴瘤及小B细胞淋巴瘤受累淋巴结融合最常见,且以腹膜后淋巴结融合为主,而外周T细胞淋巴瘤及小淋巴细胞性淋巴瘤以孤立淋巴结为主,均无1例有淋巴结融合征象;③血管包埋征:淋巴结融合包埋大血管时形成血管包埋征,所有被包埋的血管均未发现有血管管腔的不规则、狭窄以及管壁的毛糙。结论:非霍奇金淋巴瘤深部淋巴结受累时,以腹膜后淋巴结受累最常见,腹腔淋巴结次之;血管包埋征在淋巴瘤CT诊断中具有重要价值,其对血管的包埋而非侵蚀是与其它恶性肿瘤相鉴别的一个重要特点。
Objective：To investigate the manifestations of non-hodgkin＇s lymphoma involving deep lymph nodes and large vessels on contrast-enhanced multi-slice spiral CT.Methods：We retrospectively reviewed the CT imagings of 62 cases of pathologically proved non-hodgkin＇s lymphoma（NHL） with deep lymph nodes and large vessels involved,including 38 cases of diffuse large B-cell lymphoma,13 peripheral T-Cell Lymphoma,3 follicular lymphoma,3 mantle cell lymphoma,3 small B-cell lymphoma and 2 small lymphocytic lymphoma.Results：① Distribution site： all pathological types of non hodgkin lymphoma mainly involved retroperitoneal and abdominal lymph node,as well as mediastinal and pelvic lymph nodes in some cases;② Discreteness and coalesce： lymph nodes especially retroperitoneal involved by Diffuse large B cell lymphoma,mantle cell lymphoma and small B cell lymphoma tends to be coalesce,but lymph nodes involved by peripheral T-Cell Lymphoma and small lymphocytic lymphoma are all discrete;③ ＂vascular embedding＂ sign： when large vessels embedded by discrete lymph nodes,＂vascular embedding＂ sign was formed,all embedded vascular had no sign of luminal irregularity,stenosis and rough wall.Conclusion：Non-hodgkin＇s lymphoma with deep lymph node involvement mainly involved retroperitoneal lymph node,followed by abdominal lymph nodes.＂Vascular embedding＂ sign,which indicates no luminal irregularity,stenosis and rough wall,is helpful for the differentiation from other malignant tumors.
出处
《医学影像学杂志》
2011年第9期1341-1344,共4页
Journal of Medical Imaging
