胸腹部Castleman病的CT诊断

CT diagnosis of Castleman's disease in chest or abdomen

目的分析Castleman病的CT表现,提高对胸腹部Castleman病CT特征的认识。方法回顾性总结经手术病理证实的8例Castleman病患者的临床资料、CT表现。结果病变位于纵隔及纵隔伴肺门部5例(占62.5%),腹膜后3例(占37.5%)。所有病灶均表现为边缘光滑清楚的软组织密度团块,其中7个病灶密度均匀,1个病灶伴钙化。增强扫描后所有病灶均有不同程度强化,7个病灶呈明显强化,病理为透明血管型,1个病灶轻度强化,病理为浆细胞型。结论 Castleman病缺乏特征性临床表现,中央型分支状钙化和病灶显著均匀强化是局限性Castleman病定性诊断的重要特征。

Objective To improve the recognition of CT characteristics of castleman＇s disease in chest or abdomen.Methods CT findings in 8 cases with castleman disease confirmed by pathology were retrospectively analyzed.Results The lesions located in the mediastinum and the mediastinum with pulmonary hilar in 5 cases（62.5%）,3 cases of retroperitoneal（37.5%）.All lesions found well-circumscribed soft tissur-attenuating masses,7 lesions were homogeneous density,only 1 lesion had calcifications.All cases were enhanced,the degree of enhancement varied from minimally to markedly increased attenuation.7 lesions were hyaline-vasculartype enhanced medially or markedly.One case was plasma-cell type,lightly enhanced.Conclusion Castleman＇s disease lack of characteristic clinical manifestations,central arborizing calcification and marked enhancement after contrast administration are most important and specific findings in definite diagnosis of localized castleman＇s diseases.