原发性甲状腺淋巴瘤的CT表现

CT Features of Primary Thyroid Lymphoma

目的探讨原发性甲状腺淋巴瘤(primary thyroid lymphoma,PTL)的CT特征。方法回顾性分析9例经手术病理证实的PTL的CT与临床相关资料。结果弥漫大B细胞淋巴瘤8例,粘膜相关淋巴组织淋巴瘤1例,其中单发结节型2例,多发结节型3例,弥漫肿大型4例。CT平扫7例呈稍低密度,2例呈等密度,8例肿块密度均匀,1例中心见囊变坏死,均无钙化。动态增强:8例呈均匀轻度强化,1例中心伴囊变,囊壁呈环状明显强化,实性区呈不均匀中度强化。3例甲状腺包膜完整,6例病灶甲状腺包膜不完整,侵犯邻近结构,4例伴颈部或上纵膈淋巴结肿大。结论 PTL具有一定CT特征,以弥漫肿大型多见,沿甲状腺轮廓塑形、膨胀生长,多呈均匀低密度,增强扫描呈轻中度均匀强化,确诊仍需结合穿刺活检。

Objective To investigate the CT features of primary thyroid lymphoma（PTL）. Methods CT findings and clinical datas of 9 cases with PTL proved by pathology were retrospectively analyzed. Results There were 8 cases of diffuse large B-cell lymphoma, 1 case of mucosal-associated lymphoid tissue lymphoma, including 2 cases of solitary nodule type; 3 cases of multiple nodules type, 4 cases of diffuse swelling type. On CT scan, 7 cases showed slightly low density, 2 cases showed equal density, and 8 cases with uniform mass density, 1 case can be seen cystic necrosis at centerwithout calcification. Dynamic enhancement： 8 cases showed homogeneous mild enhancement, 1 case with cystic showed cyst wall annular significantly enhanced, solid areas showed heterogeneous moderately enhancement. 3 cases with thyroid encapsulated 6 cases with incomplete capsule and invased adjacent structures, 4 cases with lymph nodes at cervical or upper mediastinal. Conclusion PTL has certain CT features, mostly were diffuse swelling type, grew along thyroid contour shaping, mostly showed uniform density and enhanced of mild to moderate homogeneous, combined with biopsy to diagnose the disease.