头颈部淋巴瘤的影像特征及临床病理分析

The imaging findings and clinical pothological characteristics of the lymphoma in head and neck

目的探讨头颈部淋巴瘤的CT与磁共振成像(MRI)特点及临床病理特点。方法收集37例经手术病理或穿刺活检证实的颈部淋巴瘤患者的临床病理资料及CT、MRI资料,所有患者均行CT平扫及增强扫描,11例行MRI平扫,其中3例行MRI增强扫描。分析其影像表现及临床、病理特点。结果 37例中29例为非霍奇金淋巴瘤(NHL),8例为霍奇金淋巴瘤(HL)。累及部位包括鼻咽、鼻腔、扁桃体、舌根、甲状腺及颈部淋巴结。16发生颈部淋巴结转移。淋巴瘤在CT图像呈等密度,增强扫描明显均匀强化,其中2例病变内出现坏死样低密度区。MRI扫描T1WI呈等高信号,T2WI及抑脂序列为高信号,增强扫描呈明显均匀强化。结论颈部淋巴瘤的CT、MRI表现有一定特点,对淋巴瘤的诊断、鉴别诊断及观察侵犯范围有一定价值。

Objective To detect the MRI and CT findings of the head and neck lymphoma, and to analyze the clinical and pathological characteristics of lymphoma. Methods Thirty-seven cases were examined by plain and enhancement CT scanning. Eleven cases were examined by MRI, 3 cases were examined by MRI enhancement scanning. Diagnostic value of the CT and MRI findings and correlation with their operation and pathology were an- alyzed. Results Twenty-nine cases of lymphoma in neck are non-Hodgkin＇s lymphoma（NHL）and 8 cases are Hodgkin＇s lymphoma （HL）, The parts were infringed include nose pharynx, nasal, tonsil, the bases of tongue thyroid and lymph node of neck. CT images displayed homogeneous isodense or hyperdense tissue, and obvious homogeneous enhancement was also performed after injection of contrast agents. Two cases of lesions necrosis showed low density area. MRI showed isointensity on T1W] and hyperintensity on T2WI and fat inhibit sequence, and also obvious enhancement was also performed after injection of Gd-DTPA. There was no lymph node metasta- sis in the neck. The lymph nodes metastases in the neck were observed in 13 of 21 cases of malignant lymphoma. Conclusion CT and MRI could indicate the location, morphology, surrounding tissue and lymph nodes metastases of malignant lymphoma in neck. They have great value in clinical diagnosis and treatment.