白血病的胸腹部CT特征性表现及其病理对照

Study of CT feature and its pathological control of leukemia in thorax and abdomen

目的探讨白血病胸腹部CT特征性表现及病理对照,以提高该疾病的诊断水平。方法回顾性分析2012年5～10月经本院病理科确诊的30例白血病肺部浸润患者的临床资料,并进行CT与病理的对照分析。结果胸腹部浸润的CT扫描显示:脾大占了较大比例(22例,73.3%);脾浸润主要表现为单(或多)个低密度结节影,边界清晰,少数伴有出血现象存在,低密度结节影弱化。淋巴结肿大的肿大程度主要为轻、中度。胸部改变主要为肺部及胸膜浸润,分别占50.0%(15/30)和36.7%(11/30)。患者均伴有不同程度的继发感染、持续性弛张热、出血、贫血等症状,并存在白血病细胞的增生与浸润及高度脾大。结论胸腹部CT有助于脾及肺浸润的诊断,结合病理,可提高疾病的诊断效率,避免误诊或漏诊。

Objective To explore the CT feature and its pathological control of leukemia in thorax and abdomen, in or- der to improve the diagnosis for this disease. Methods The clinical data of thirty cases of leukemia patients with lung infiltrates diagnosed by pathology department of our hospital from May to October 2012 were retrospectively analyzed, and contrast analysis of CT and pathology were given. Results The CT scan of belly infiltrating showed that big splenomegaly was accounted for a larger percentage （22 cases, accounted for 73.3%）, spleen infiltration was mainly single （or more） low density nodules shadow, boundary was clear, the minority with bleeding phenomenon existed, low density nodules shadow was weakening. The enlargement of lymph node enlargement was mainly light and moderate. Chest change was mainly for lung and pleural infiltration, the rate was 50.0% （15/30） and 36.7% （11/30） respectively. All patients had symptomes such as secondary infection, persistent remittent fever, bleeding, and anemia in the differ- ent degree, and leukemia cell proliferation and infiltration and highly splenomegaly existed. Conclusion CT in thorax arid abdomen is benefit for diagnosis of infiltration in spleen and lung, it can improve efficiency of diagnosis for dis- eases combined with the pathology, and to avoid misdiagnosis or missed diagnosis.