腮腺及淋巴结木村病的多层螺旋CT表现

The multi-slice spiral CT imaging manifestation of Kimura disease involving the parotid gland and lymph node

目的探讨木村病(KD)的多层螺旋CT特征,结合其临床表现,旨在提高对该病的认识和诊断水平。方法回顾性分析经病理确诊的12例KD的临床和多层螺旋CT表现。结果 12例中,8例出现一侧或双侧的腮腺肿大,2例出现腹股沟淋巴结肿大,1例出现耳后淋巴结肿大,1例出现全身多发肿大的淋巴结。CT表现为单侧或双侧腮腺弥漫性肿大,内伴有多个大小不一结节形成,伴有邻近引流区淋巴结肿大,平扫呈等密度或稍高密度,增强扫描病灶中度均匀强化,边界较清晰;亦可以表现为双侧腹股沟或全身多发大小不一淋巴结肿大,平扫呈等密度肿大淋巴结,增强扫描中度均匀强化,淋巴结无融合趋势,亦未见包绕血管征象。结论 KD具有无痛性大涎腺及邻近皮下组织缓慢肿大的肿块,伴有或仅单独出现引流区域的多发淋巴结肿大,或出现全身多发淋巴结肿大,无坏死及融合,外周血嗜酸性粒细胞升高等特征。

Objective To explore the characteristics of multi-slice spiral CT（MSCT） imaging of Kimura disease, and to raise awareness of the disease and improve the diagnosis level in combination with its clinical manifestation. Methods The clinical and multi-slice spiral CT imaging manifestation of 12 cases pathologically diagnosed with KD were retrospectively analyzed. Results Among the 12 patients, eight cases had enlargement in unilateral or bilateral parotid gland, 2 cases had enlargement in inguinal lymph nodes, one case had enlargement in nodi lymphatici retroauriculares, and one case had systematic and multiple enlargement in lymph nodes. CT showed diffuse enlargement in unilateral or bilateral parotid gland internally complicated with the formation of multiple nodule with different sizes and complicated with enlargement in lymph nodes in neighboring drainage area, plain scan showed equidensite or slightly high density, enhanced scan showed moderate and homogeneous enhancement in the lesion with a clear boundary; and also enlargement in bilateral groin and systematic and multiple lymph nodes enlargement with different sizes, plain scan showed the lymph nodes with equidensity enlargement, enhanced scan showed moderate homogeneous enhancement, there was no integration trend of lymph nodes. Conclusion KD had painless enlargement of the major salivary glands and mass slowly enlarging in adjacent subcutaneous tissue complicated with or only had multiple enlargement in lymph nodes in drainage area, or has systemic and multiple enlargement in lymph nodes with no necrosis and fusion and peripheral blood eosinophilia.