骨原发性淋巴瘤的CT、MRI表现及病理分析

CT,MRI Features and Pathological Analysis of Primary Lymphoma of Bone

目的探讨骨原发性淋巴瘤的CT、MRI表现。方法回顾性分析19例骨原发性淋巴瘤的CT、MRI影像资料,并结合文献及病理分析。结果 19例均为单骨发病,脊柱10例,骨盆6例,股骨3例。骨质均呈侵润性破坏,CT呈斑片状、虫蚀状溶骨性破坏,MRI呈稍长T1、T2信号(抑脂序列),内可伴更长T2信号,周围均伴软组织病灶且范围多大于骨内病灶。CT增强3例中软组织病灶明显均匀强化1例、轻度均匀强化2例。MRI增强15例中骨内病灶明显强化12例,其中呈"镶边征"10例,轻度强化3例;周围软组织病灶明显强化9例,伴坏死2例,轻度至中度均匀强化6例。病理上均为B细胞源性,且多为弥漫性大B细胞淋巴瘤。结论骨原发性淋巴瘤的CT、MRI表现有一定的特征性,MRI对PLB定性诊断有较高的诊断价值,结合好发部位及年龄,应考虑到PLB的可能性。

Objective To study CT and MRI features of primary bone of the lymphoma. Methods Imaging of 19 PLB with pathologically confirmed were retrospectively reviewed. Results All lesions affected single bone, backbone 10, pelvis 6, femur 3. All bone lesions were infiltrative destruction with soft-tissue masses, CT scans displayed areas of different sizes of osteolytic cortical and marrow cavity destruction with large soft tissue masses or focus around the lesion. All of the lesions showed hypo-intense signal on T1WI and slightly hyperintense signal on T2WI. 1 soft-tissue lesion obviously uniform enhanced and 2 lesions slightly uniform enhanced after contrast-enhanced scans on CT; 12 lesion in bone obviously enhanced and 10 of 12 lesions with＂lace-like sign＂, 3 lesions in bone slightly enhanced after contrast-enhanced scans on MRI; 9 lesions of soft-tissue masses obviously enhanced on MRI, only 2 lesion with necrosis, other 6 soft-tissue lesions slightly-moderate enhanced. Histological examination all identified B-cell lymphoma, 16 of them were diffuse larger B-cell lymphoma. Conclusion CT, MRI imaging of PBL has some characteristics, MRI has higher diagnostic value of PLB. associated with predilection site and age should be considered PBL possible.