鼻-鼻咽NK-T型淋巴瘤的影像学表现

Imaging Features of Nasal and Nasopharyngeal NK-T Lymphoma

目的探讨鼻及鼻咽NK-T型淋巴瘤的影像学表现特点,提高对此病诊断率。方法回顾性分析10例发生于鼻及鼻咽部NK-T非霍奇金淋巴瘤CT、MRI及临床资料,分析此病所具有的典型特点。结果 10例中仅鼻腔病变有5例,呈铸型生长,其中2例累及下鼻甲、鼻中隔,4例鼻翼及鼻背部受累;仅鼻咽病变有1例,增厚的鼻咽部表面不规整,复查增厚鼻咽表面较光整,增强可见鼻咽部分粘膜线清晰。累及咽淋巴环3例。累及鼻腔及鼻咽有2例,其中1例合并咽淋巴环受累,CT表现软组织密度欠均匀,增强轻-中度强化。MRI上TIWI低信号,T2WI高信号。10例中,合并肺部病变有1例,左下肺单发结节,可见分叶及毛刺征象,边缘可见晕征。结论鼻及鼻咽NK-T型淋巴瘤,常累及中线结构,易侵犯鼻背及鼻翼旁软组织,密度或信号不均匀;合并肺部浸润改变,患者预后差。

Objective To investigate the imaging performance characteristics of nasal and nasopharyngeal NK-T lymphoma and improve its disease diagnosis rate. Methods The CT, MRI and clinical data of 10 cases of nasal and nasopharyngeal NK-T Non-Hodgkin lymphoma were analyzed retrospectively for the study of the disease’s typical characteristics. Results There were only five cases of pathological change in nasal cavity with a mold growth, two of them involved the inferior turbinate and nasal septum, and four cases involved the nosewing and nasal dorsum. There was only one case of nasopharyngeal disease. The scan showed that the surface of thickened nasopharynx was irregular. In the review, the surface of thickened nasopharynx was regular. The mucosa line in the nasopharyngeal region was distinct in the enhanced scan. Pharyngeal lymphatic loop was involved in 3 cases, nasal cavity and nasopharynx involved in 2 cases, and one of them involved pharyngeal lymphoid ring with the CT manifestation of heterogeneous soft tissue density and moderate enhancement. The MRI shows low signal in TIWI and high signal in T2 WI. In the ten cases, there was one pulmonary lesions with solitary nodule occurring in the left lower lobe with lobulated shapes, specular and halo sign in the margin. Conclusion Nasal and nasopharyngeal NK-T type lymphoma was usually involved in the midline structure and easily infringed upon nasal dorsum and nasal soft tissues with uneven density or signal. It would be a poor prognosis with pulmonary involved.