肺原发性淋巴瘤的多层螺旋CT诊断

MSCT diagnosis of pulmonary primary lymphoma

目的探讨肺原发淋巴瘤的多层螺旋CT特征,提高对本病的认识。方法回顾性分析经病理证实的肺原发淋巴瘤21例多层螺旋CT表现。结果 21例患者均为非何杰金淋巴瘤,其中黏膜相关淋巴组织结外边缘区B细胞淋巴瘤16例,高度恶性弥漫性大B细胞非霍奇金淋巴瘤4例,T细胞淋巴瘤1例。结节和肿块型8例,肺炎肺泡型7例,混合型6例。病灶内可见支气管充气征14例,病灶周边可见小叶间隔增厚4例,可见病变跨叶生长2例,合并胸腔积液5例。结论肺原发淋巴瘤多层螺旋CT表现多样,沿肺间质分布的多发肿块或边缘清晰的实变伴支气管壁增厚,病变周边小叶间隔增厚,抗感染治疗无效,可以提示肺淋巴瘤的诊断。

Objective To study the CT features of pulmonary primary lymphoma in order to improve the understanding of this disease .Methods CT findings of 21 cases with lung primary lymphoma confirmed by pathology were retmspective-ly analyzed .Results 21patients were non-hodgkin lymphoma ,of which 16 cases were mucosaassociated lymphoid tissue lymphoma ,4 were high grade malignant Diffuse large B-cell lymphoma ,1 case was T cell lymphoma .8 cases were mass or nodular type ,7 cases were pneumonic-type ,and 6 cases were consolidation-type .14 cases showed air bronchogram ,4 ca-ses showed perifocal interlobular septal thickening ,2 cases showed cross lobe growing ,and 5 cases showed merger pleural effusion .Conclusion Pulmonary primary lymphoma shows the diversity with multidetector-row CT .The distribution of interstitial lung masses or the clearly edge lesion with bronchial wall thickening ,and peripheral lobular septal thickening , may be pulmonary lymphoma ,especially anti-infection treatment is invalid .