巨大淋巴结增生症的CT及MRI表现

CT and MRI findings of Castleman disease

目的:探讨巨大淋巴结增生症的影像学特征。方法:回顾性分析经手术病理证实15例患者的CT或MRI表现。结果:病理类型为局限型透明血管型13例;混合型和浆细胞型各1例,均为弥漫型。CT或MRI平扫,3例透明血管型中间可见斑点状或分支状钙化;2例弥漫型内见点状钙化;3例伴有子灶。8例透明血管型增强后动脉期明显强化,门静脉期及延迟后持续强化,强化方式与大血管相似。4例透明血管型中间和(或)周围见迂曲扩张血管影;4例透明血管型(>4 cm)动脉期病灶内见条片状、裂隙状低密度区或低信号区,延迟后2例由周围逐渐向中心强化,2例未见强化;5例透明血管型中度强化,2例弥漫型呈轻-中度强化。结论:CT及MRI能清晰显示该病的特征,熟悉这些特征对于提高诊断准确率、避免误诊具有重要意义。

Objective： To analyze the imaging features of Castleman disease（CD）. Methods： A total of 15 patients with Castleman disease were performed CT or MRI scan and proved by pathology. Results： Among the patients, 13 localized cases were hyaline vascular type（HVT）, 1 diffuse case was mixed type, and 1 diffuse case was plasma cell type（PCT）. On CT or MRI scan, 3 cases of HVT showed punctate or bifurcate calcifications. 1 case of PCT and 1 case of mixed type showed punctate calcifications. 3 cases had small satellite nodules. A significant enhancement was shown in 8 cases of HVT in arterial phase, with nearly the same enhancement level compared with vessels. In portal venous phase and delayed phase the enhancement continued. Enlarged blood vessels within or around the mass were displayed in 4 cases of HVT. In 4 cases of HVT, the intratumoral radial or fissured nonenhanced areas in early stage of enhancement were gradually filled up（2 cases） or still obviously existed（other 2 cases） as the scan time was delayed. 5 cases of HVT displayed moderate enhancement. 2 diffuse cases showed mild-moderate enhancement. Conclusion： The characteristics of CD can be showed clearly by CT and MRI. It is important to be familiar with these characteristics to improve the diagnostic accuracy and to avoid misdiagnosis.