鼻咽非霍奇金淋巴瘤的影像诊断

Radiological Diagnosis of Nasopharyngeal Non-Hodgkin's Lymphoma

目的:探讨鼻咽非霍奇金淋巴瘤(NHL)的影像学特征。材料与方法:回顾性分析经病理证实的28例鼻咽NHL的MR或CT表现,其中22例行CT检查,6例行MR检查。观察肿块的形态、有无坏死、邻近结构及颈部淋巴结浸润的特点。结果:16例表现为鼻咽粘膜对称性或大致对称性弥漫性增厚,12例表现为鼻咽顶后壁和(或)一侧壁局限性增厚,形成软组织肿块,并突向鼻咽腔。25例密度(信号)强化均匀。病灶累及口咽壁者14例,其中腭或(和)舌根扁桃体浸润4例;累及喉咽2例;累及鼻腔4例;枕骨斜坡受侵并累及颅底肌肉1例。17例患者合并颈部淋巴结肿大,其中4例内出现坏死。结论:鼻咽NHL常侵犯鼻咽多个侧壁,病灶及淋巴结坏死少见,很少累及颅底骨质,易向下蔓延至咽淋巴环其他部位。影像学检查对其诊断、鉴别诊断及病灶范围的判断有重要价值。

Objective： To investigate the radiological findings of nasopharyngeal non-Hodgkin＇s lymphoma （NHL）. Materials and Methods： The CT images of 22 patients and MRI images of 6 patients with pathologically confirmed nasopharyngeal NHL were retrospectively analyzed. All nasopharyngeal NHL were assessed for morphology, necrosis,local invasion and lymphadenopathy. Results： 16 cases presented the walls of nasopharynx symmetrically or general symmetrically diffuse thickening, and 12 cases presented soft tissue masses on the hanging posterior and （or） lateral walls of nasopharynx. 25 cases were homogeneous. 14 cases invaded the oropharynx, palatine and/or lingual radix tonsil swollen in 4.2 invaded the laryngopharynx. 4 invaded nasal cavity. 1 invaded clivus and adjacent muscles, Lymphadenopathy was found in 17, with necrosis in 4. Conclusions： There were typical features of nasopharyngeal NHL on MRI or CT. Nasopharyngeal NHL usually invaded mutiple walls of nasopharynx, and more than half were lymphadenopathy. Both of the tumour at nasopharynx and lymphadenopathy were homogeneous, necrosis uncommon. Skull base or the deep structures invasion were rare. The lesions could spread down invading the other parts of Waldeyer ring.