原发性肝淋巴瘤的超声表现与临床病理分型

Primary hepatic lymphoma： ultrasound and pathology

目的探讨原发性肝淋巴瘤的超声表现与病理分型的关系。方法总结经手术或超声引导下穿刺后病理证实的26例原发性肝淋巴瘤患者的超声表现及病理诊断。结果肝淋巴瘤单发15例（57．7％），多发7例（26．9％），弥漫性4例（15．4％）。单发及多发性病例的超声表现相似，86．4％（19／22）表现为低回声病灶；其病理诊断均为非霍奇金淋巴瘤B淋巴细胞表型。弥漫性病例声像图表现为肝肿大，弥漫性回声不均匀，似“慢性肝病”或“脂肪肝”，未见明确占位病灶，其病理诊断均为非霍奇金淋巴瘤T淋巴细胞表型。结论根据超声表现，可将原发性肝淋巴瘤分为单发型、多发型及弥漫型；其中，单发型与多发型的声像图以低回声占位为主，而弥漫型表现为肝肿大；该分型与病理免疫组化T、B淋巴细胞分型高度相关。

Objective To investigate the relationship between ultrasound features and pathological types of primary hepatic lymphoma （PHL）. Methods Ultrasound and pathological features in 26 cases of PHI. were analyzed retrospectively. Results The most common presentation of PHL was a solitary lesion, which occurred in about 57.7% （15/26） of cases,followed by multiple lesions in about 26.9% （7/26） of patients,and least commonly as diffuse infiltration patterns in about 15.4% （4/26） cases. The first two types were similar and usually demonstrated as hypoechoic lesions to the surrounding normal liver parenchyma in 86.4%（19/22） of cases on ultrasound. All the cases were B-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations. The diffuse pattern demonstrated diffuse hepatomegaly without nodular, which were T-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examinations. Conclusions PHL could be divided into single, multiple and diffuse types on ultrasound. The single and multiple types mainly present as hypoechoic lesions and the diffuse type shows hepatomegaly on ultrasound, which are closely related to histology and T or B-cell phenotype on immunohistochemical examination.