鼻腔NK/T细胞淋巴瘤的CT及MRI诊断

CT and MRI Diagnosis of Nasal Natural Killer Cell/T Cell Lymphomas

目的分析和总结鼻腔自然杀伤细胞/T细胞淋巴瘤(NKTCL)的CT及MRI表现特点。方法回顾性分析34例经组织病理证实的鼻腔NKTCL的影像学资料。结果病灶位于一侧鼻腔21例,双侧鼻腔13例。CT检查29例,病灶密度均匀7例,不均匀22例;增强扫描10例,均呈轻中度强化。骨质破坏15例,呈轻微浸润性骨质破坏。MR检查11例,T1WI表现为等信号10例,1例呈混杂信号;T2WI呈稍高信号5例,等信号5例,混杂信号1例;增强扫描7例,病变轻度强化3例,中度强化3例,重度强化1例。33例(33/34)肿瘤伴邻近结构侵犯,多见于鼻翼、鼻后孔、鼻咽、鼻旁窦、颊面部软组织及翼腭窝等部位。结论鼻腔NKTCL极易累及邻近结构而骨质结构轻微破坏,出现此征象可提示诊断。

Objective To investigate CT and MRI features of natural killer cell/T cell lympbomas in nasal cavity. Methods The imaging materials, including CT and MRI scanning, of 34 with histopathologically-proved natural killer cell/T cell lymphoma in nasal cavity were retrospectively analyzed. Results Of the 34 patients, the lesion was located at unilateral nasal cavity in 21 and at bilateral nasal cavities in 13. The CT scanning was performed in 29 cases, which showed that the lesions were homogeneous in density （ n = 7） or inhomogeneous in density （ n = 22）. Contrast-enhanced CT scanning was carried out in 10 cases. On enhanced CT scans, the lesions displayed mild to moderate enhancement in all 10 cases. Bony destruction was noted in 15 cases, which presented as slightly infiltrative bony destruction. MRI scanning was employed in 11 cases. The lesions on T^WI were iso-intense signal in 10 cases and mixed signal intensity in one case. On T2WI, the lesions were high-signal in 5 cases, iso-signal in 5 cases and mixed signal intensity in one ease. Contrast-en- hanced MRI scanning was adopted in 7 cases. The lesions showed mild enhancement in 3 cases, moderate enhancement in 3 cases and marked enhancement in one case. Involvement of the adjacent structures was noted in 33 cases, including nasal ala, posterior nasal apertures, paranasal sinuses, nasopharynx, facial subcutaneous soft tissue, pterygopalatine fossa, etc. Conclusion Nasal natural killer cell/T cell lymphoma has a high predilection to involve its adjacent structures, presenting as slight bony destruction, which is very suggestive of the diagnosis.