Castleman病影像学表现与病理对照分析

Castleman disease:a comparative analysis of imaging and histopathologic features

目的探讨Castleman病(CD)的影像学表现及其与临床和病理的联系。方法回顾性分析20例CD患者的影像学资料,并与临床和病理结果进行对比分析。所有患者均进行CT或MRI平扫和增强,CT检查12例,MRI检查8例。结果病变部位:6例位于颈部,6例位于腹腔,3例位于纵隔,2例位于腹膜后,2例多部位,1例位于左锁骨下。临床分型:单中心型17例,多中心型3例。病理分型:透明血管型16例,浆细胞型3例,混合型1例。平扫3例表现为浅分叶状,3例边界模糊,5例多发肿块,1例质地不均匀,其余肿块均表现为质地均匀、边界清楚光整的软组织块影。增强后19例表现为肿块显著或明显持续强化,1例轻度强化;14例均匀强化,6例不均匀强化;17例肿块周围可见供血血管。结论 CD的影像学表现与临床和病理分型密切相关,掌握其影像学表现有助于术前对病变的全面了解,从而初步判断病变的性质和制定合适的治疗方案。

Objective To analyze the imaging features of Castleman disease（CD）and its correlation with histopathologic and clinical features.Methods The images of 20 patients with CD were retrospectively reviewed and compared with their clinical and pathological findings.All the patients received CT or MRI plain scan and dynamic enhanced scan.12 patients underwent CT examination and 8underwent MRI examination.Results Locations of the lesions were found in the neck（n=6）,abdomen and pelvis（n=6）,mediastinum（n=3）,retroperitoneum（n=2）,multiple locations（n=2）and left subclavicular region（n=1）.The clinical subtypes included unicentric type（n=17）and multicentric type（n=3）.Histopathologic classification was as follows：hyaline-vascular type（n=16）,plasma cell type（n=3）and mixed cell type（n=1）.The lesions were manifested as homogeneous masses and well-defined margins of soft-tissue attenuation on the plain scan,apart from three cases with lobular,three cases with unclear margins,five cases with multiple masses and one case with heterogeneous texture.After contrast administration,19 cases showed marked or persistent enhancement,one showed slight enhancement;14showed homogeneous enhancement,six showed heterogeneous enhancement;and 17 showed enlarged blood vessels within or around the mass.Conclusion Imaging features of CD are closely correlated with its clinical and pathological subtypes.A good knowledge of imaging features can contribute to a better understanding of the lesion before operation and a suitable therapeutic regimen.