恶性肉芽肿的CT、MRI诊断及病理探讨

CT, MRI and Pathology Study of Malignant Granuloma

目的 探讨恶性肉芽肿的CT、MRI诊断及病理表现。方法 9例患者 ,男 7例、女 2例 ,均行CT、MRI检查 ,病理证实为恶性肉芽肿。结果 发生于鼻面部 8例 ,表现为鼻腔、鼻中隔、鼻甲、上颌窦、筛窦、蝶窦黏膜增厚 ,左右大致对称 ,不同程度骨质破坏 ,7例有软组织肿块 ,5例邻近脑组织受累。中耳病变 1例表现为软组织肿块和骨质破坏。所有病灶在T2 WI信号强度并非很高 ,表现为等或略高信号。增强扫描病变呈明显强化。病理显示有较多的淋巴细胞、浆细胞浸润 ,4例经免疫组化染色进一步证实为T淋巴细胞性淋巴瘤。结论 CT、MRI均能很好地显示病变部位和范围 ,观察软组织情况以MRI为佳 ,T2 WI病灶呈略高信号 ,骨质破坏情况CT更可靠 。

Objective To evaluate CT and MRI in diagnosis of granuloma. Methods 9 cases (male 7 cases, female 2 cases)were scanned with CT and MRI. Pathologic diagnosis was malignant granuloma. Results 8 occurred in midline facial structure. The mucosas of nasal cavity, nasal septum, concha, and nasal sinuses were showed thickened symmetrically, destruction of bones, 7 showed soft tissue masses, 5 showed their brains were involved. Only 1 occurred in middle ear, showed destruction of bone and soft tissue mass. All were enhanced after injecting contrast through veins. Pathology showed more lymphocytes and plasmocytes, 5 were made sure of T cell lymphoma. Conclusion Both CT and MRI can show satisfactorily the locations and ranges of lesions.