原发性肠道淋巴瘤的多层螺旋CT表现及病理对照分析

Comparative Study of Multi-slice Spiral CT Findings with Pathology in Primary Intestinal Lymphoma

目的:探讨原发性肠道淋巴瘤的多层螺旋CT表现。方法:回顾性分析我院2007年1月至2013年8月经手术病理证实的30例原发性肠道淋巴瘤的临床及影像学资料。结果:单发24例,其中位于小肠8例,回盲部6例,结肠4例,直肠3例,十二指肠2例,肛管1例。多发6例,其中病变位于多个节段小肠3例,位于回盲部、直肠2例,位于多个节段小肠、结肠1例。浸润型16例,肠壁弥漫均匀或不均匀的增厚,受累肠管范围较长,最长约35.6cm。4例可见肠管扩张。肿块型11例,其中8例肿块突向肠腔内生长,3例突向肠腔外生长。多发结节型2例,表现为多个结节突向肠腔内生长。混合型1例。原发性肠道淋巴瘤的并发症少见,仅2例伴有肠梗阻,1例肠套叠,1例肠穿孔。结论:原发性肠道淋巴瘤的多层螺旋CT表现有一定特征,多层螺旋CT对其诊断具有重要意义。

Purpose： To investigate the multi-slice spiral CT findings of primary intestinal lymphoma （PIL）. Methods： Thirty patients with PIL confirmed by surgery and pathology between January 2007 and August 2013 were enrolled in this study. The clinical features and MSCT findings were analyzed retrospectively. Results： Twenty-four cases demonstrated single lesion. The lesions located at small intestinal in 8 eases, ileoeeeus in 6 cases, colon in 4 cases, rectum in 3 eases, duodenum in 2 cases, and anal canal in 1 case. Six cases demonstrated multiple lesions. Three cases involved multiple segments of small intestinal loops, 2 cases simultaneously involved ileocecus and rectum, and 1 case simultaneously involved small intestine and colon. The infiltration type in 16 cases manifested as uniform or irregular thickened wall. The involved extent was long, and the longest segment was 35.6cm. Dilation of intestinal loop could be seen in 4 cases. Eleven cases manifested as soft tissue tumor type, 8 of which mainly located in the enteric cavity, 3 mainly located out of the enteric cavity, 2 cases manifested as multiple nodule protruding into enteric cavity, and 1 case manifested as mixed type. Complications were rare, only 2 cases were with concomitant intestinal obstruction, 1 case with intussusception, and 1 case with enterobrosis. Conclusion： There are some characteristic findings of primary intestinal lymphoma on MSCT, and MSCT is valuable in the diagnosis of primary intestinal lymphoma.