肺淋巴瘤的CT表现

CT Findings of Pulmonary Lymphoma

目的:肺部淋巴瘤可为原发,亦可为其他部位淋巴瘤的肺部浸润,临床上很少见。准确的影像学诊断对于采取及时的治疗措施具有重要意义,然而该病影像学表现复杂多变,容易与多种其他肺部病变混淆,以往文献对于肺部淋巴瘤的CT影像特征性表现报道不多,本文旨在探讨肺部淋巴瘤的特征性CT表现,以提高该病影像诊断的准确率。方法:回顾性分析17例病理证实的肺淋巴瘤患者CT资料,分析特征性影像表现。结果:17例中多发者13例,单发者4例。叶段性或斑片状实变影13例,多发结节影13例,肿块状实变影8例,具有两种以上病灶的12例。特征性的征象有:病灶密度均匀(88.2%,15/17)、病灶边缘模糊(82.3%,14/17)、支气管气相(64.7%,11/17)、支气管血管束增厚(58.8%,10/17)和CT血管造影征(41.2%,7/17),对诊断有较大意义。结论:肺部淋巴瘤CT表现以多发、多形态病变居多,具有一定特征性影像表现,密度均匀、边缘模糊的实变、团块或结节影,具有支气管气相、支气管血管束增厚、增强扫描可见CT血管造影征等表现可高度提示本病的可能,结合病史、临床表现以及实验室检查,可提高本病的诊断准确率,对于及时开展有效的治疗措施、改善患者预后具有重要的临床意义。

Objective： Pulmonary lymphoma can be primary lesion or secondary infiltration of lymphoma originated from other organs, which is fairly rare clinically. Accurate radiological diagnosis is very important for applying appropriate therapy. But the radio- logical manifestation of pulmonary lymphoma is very complicated and variable, and is likely to be confused with other pulmonary le- sions. The characteristic CT findings of pulmonary lymphoma were not well documented in previous literatures. The aim of this article is to investigate characteristic CT findings of pulmonary lymphoma and to improve the accuracy of radiologieal diagnosis of this disease. Methods： CT imaging data of 17 pathologically confirmed pulmonary lymphoma cases were retrospectively reviewed, characteristic CT findings were analyzed. Results： Multiple pulmonary lesions were identified in 13 of 17 cases and solitary lesions in 4 of 17 cases. Lobar, segmental or patchy consolidation lesions were present in 13 cases, multiple nodules were revealed in 13 cases, and mass lesions were shown in 8 cases. Characteristic findings include： homogeneity of lesions （88.2%,15/17）, blurring margin of lesions （82.3%,14/17）,air bronchogram（64.7%, 11/17）,peribronchovascular thickening（58.8%, 10/17） and CT angiogram sign（41.2%, 7/17）, which are meaningful to diagnosis. Conclusion： Pulmonary lymphoma manifest mostly as multiple lesions of variable types on CT. There are some characteristic radiological findings of this disease. Homogeneous consolidations, masses or nodules with blurring margin combined with air bron- chogram, peribronchovascular thickening and CT angiogmm sign in contrast enhanced images highly suggest the diagnosis of pulmonary lymphoma. The accuracy of diagnosis of this disease can be improved according to these CT findings combined with history, clinical findings and laboratory examinations, which is valuable for applying appropriate therapy in time and improving the prognosis of the pa- tients.