巨大淋巴结增生症的影像学诊断

The Image Diagnoses of Castleman Disease

目的：研究巨大淋巴结增生症（Castleman Disease）的CT和MR影像表现特点，以提高对本病的认识，提高诊断准确率。方法：收集我院自1995年1月-2012年10月间，经手术病理证实的19例巨大淋巴结增生症，患者均接受CT或MRI平扫及增强扫描检查。其中，男7例，女12例，年龄19462岁，平均43．4岁。结果：19个病例中14例病灶位于胸部（胸腔或纵隔），2例位于颈部，3例位于腹膜后区，局限型16例，弥漫型3例。CT检查采用CT动态增强扫描技术，局限型病灶在动脉期可见明显强化，强化程度近似主动脉，弥漫型病灶在动脉期表现为中等程度强化，两者在延迟期均表现为持续强化。MR扫描：4例表现为T1WI低信号，1例为中等信号，T2WI均呈高信号，动态增强扫描病灶的强化方式与CT基本一致。结论：颈部、胸部或腹膜后区的富血供病变，在CT及MRI增强扫描动脉期表现明显强化，延迟期持续强化，应高度怀疑巨大淋巴结增生症的可能性。

Objective： The purpose was to investigating the CT and MRI specialty of the Castlemanps disease, and to improve cognition the Castlemanps disease and the veracity of diagnoses. Methods： From January, 1995 to October, 2012, abdominal and chest CT in 19 patients with confirmed Castleman＇s disease were retrospectively reviewed. Patients were 19-62 yeas old （mean = 43）; seven were men and twelve women. Diagnosis of Castleman disease was done by surgery and pathology. Results： The lesion was detected in 19 cases and suggestive diagnosis made in one patient. In our series, the lesions were located 15 in the chest, 4 at the retroperitoneal, with localized Castleman disease and with disseminated Castleman, at CT, all lesions show marked enhancement after contrast administration at arterial phase and delay scan and the attenuation similar to aorta, calcification was seen in one patient. 8 lesions are hypointense on T1-weighted images andl llesions hyperintese on T2 weighted images and show contrast enhancement in a similar pattern to contrast enhanced CT. Conclusion： We should be suspicion the possibility of the Castlemanps disease, when the lesion of more blood strem in the abdomen chest and cervix, which should represent obvious enhancement in the examnation of CT and MRI arterial moment, and sustaining enhancement in the delay moment.