艾滋病相关腹部淋巴瘤的临床及CT表现特征

The clinical and CT imaging features of AIDS-related abdominal lymphoma

目的:总结分析艾滋病相关腹部淋巴瘤的CT表现特征,对比非艾滋病与艾滋病相关淋巴瘤(ARL)的临床及影像学表现异同。方法:回顾性分析28例经手术病理证实的艾滋病相关淋巴瘤患者的临床及CT表现。结果:28例艾滋病相关淋巴瘤中霍奇金病1例,非霍奇金淋巴瘤27例,受累脏器包括肝脏10例、脾脏9例、胰腺6例、肾脏5例、胃肠道8例、结内病变23例。病变器官解剖结构留存,病灶多数密度均匀,呈轻中度均匀强化,小部分病变中央出现坏死,呈环形轻中度强化。淋巴结以腹主动脉周围、腹腔干周围、肠系膜、肠系膜根部最为好发。ARL病灶侵袭性高,累及范围广,对放化疗反应性较差。结论:ARL的CT表现具有一定特征性,结合临床表现,有利于提高诊断符合率。

Objective：The purpose of this study was to clarify and summarize the clinical and CT features of abdomi-nal AIDS-related lymphoma （ARL）and to compare the imaging manifestations between ARL with the lymphoma without AIDS.Methods：The clinical and CT findings of 28 patients with abdominal ARL confirmed by pathology were retrospective-ly analyzed,had the CT scan before surgery.Results：One case was Hodgkin＆#39;s disease and the other 27 cases were non-Hodgkin lymphoma （NHL）.The involved organs included 10 cases of liver involvement,9 cases of spleen,6 cases of pan-creas,5 cases of kidney,8 cases of gastrointestinal tract,23 cases of lymphadenopathy.The CT findings showed that the in-volved organs still remained their anatomic structures.A majority of the lesions presented as solid homogeneous density masses with low to middle degree dynamic enhancement.A minority showed uneven central necrosis with circle peripheral low to middle degree enhancement.Lymph node involvements were commonly seen in the para-aortic,celiac and mesentery regions.Abdominal ARLs were highly malignant with broader involvements,and less sensitive to radiation and chemothera-py.Conclusion：CT findings have some practical features on abdominal ARL,which is helpful to improve the diagnostic accu-racy by combining with clinical manifestations.