原发性胃肠道淋巴瘤的多层螺旋CT诊断及鉴别诊断（英文）

MSCT Diagnosis and Differential Diagnosis of Primary Gastrointestinal Lymphoma

【目的】分析总结不同部位胃肠道淋巴瘤的多层螺旋CT表现及鉴别诊断。【方法】回顾性分析135例经手术病理证实的胃肠道淋巴瘤患者,就胃肠道淋巴瘤的发生部位、病理类型及多层螺旋CT表现进行分析和讨论。所有病例均采用GE lightspeed 16或Siemens Somatom Definition 64层双源螺旋CT扫描。【结果】胃淋巴瘤发生率最高(69例),其次为小肠淋巴瘤(40例)。最常见的病理类型是弥漫大B淋巴瘤(87例)及MALT淋巴瘤(24例)。大多数胃淋巴瘤(60例)表现为胃壁增厚,但未见明显梗阻征象,增强扫描14例可见黏膜白线征。动脉瘤样扩张(9例)、病灶内积气(3例)及"夹心面包征"(2例)则是小肠淋巴瘤的特征性表现。结直肠淋巴瘤少见(26例),CT表现与小肠淋巴瘤相似。【结论】胃肠道淋巴瘤的MSCT表现具有一定特异性,特别是回肠淋巴瘤,有助于胃肠道淋巴瘤的诊断及鉴别诊断。

[Objective] To analyze the imaging manifestation and to summarize differential diagnosis of different sites of gastrointestinal lymphoma. [Methods] 135 cases with gastrointestinal lymphoma were investigated retrospectively, and the sites, pathologic findings and muhi-slice spiral CT imaging manifestations were discussed. All the cases were confirmed by pathology, and were scanned by GE lightspeed 16 or Siemens Somatom Definition 64 CT machines. [ Results] Stomach was the most common site of primary gastrointestinal lymphoma （69 cases）, followed by intestinal lymphoma （40 cases）. Diffuse large B-cell lymphoma （87 cases） and mucosa-associated lymphoid tissue lymphoma （ MALT lymphoma）（24 cases） was the most common pathologic subtypes. Diffuse or focal gastric wall thickening was commonly seen （60 cases）with an absence of obviously stenosis, and ＂mucosal white line sign＂ could he seen in 14 cases. Aneurysmal dilation（9 cases）, focal pneumatosis within lesions（3 cases） and ＂sandwich sign＂ （2 cases） were the typical CT features of intestinal lymphoma. Colorectal lymphoma（26 cases） was infrequent and its CT findings were analogous to the intestinal lymphoma. [ Conclusion] Some features in MSCT findings of gastrointestinal lymphoma are typical, especially in ileum. MSCTis helpful in diagnosis and differential diagnosis of gastrointestinal Iymphoma.