艾滋病相关淋巴瘤的CT与MRI表现

CT and MRI findings of acquired immunodeficiency syndrome related lymphoma

目的探讨艾滋病患者合并淋巴瘤的CT特征和MRI表现。方法回顾性分析经病理证实的108例艾滋病合并淋巴瘤患者的CT、MRI表现。结果单纯发生在深、浅表淋巴结的51例,结内、结外均有发病38例,单纯发生于结外者19例,发生于深浅表淋巴结的病例最常见,肿瘤倍增时间短,常融合成较大团块,液化坏死常见;结外淋巴瘤表现多样,颅内发病11例表现为灶周水肿不明显的大脑深部、脑室内团块,DWI序列多为高信号,2例脑积水征象;颌面部7例表现为小血管穿行于肿块或贴近肿块走行;骨关节淋巴瘤5例,表现为溶骨性破坏伴发明显的软组织肿块;肝脏淋巴瘤12例为渐进性强化的肝内软组织团块、或沿脉管鞘生长的软组织团块,不压迫门静脉;脾脏淋巴瘤4例,脾大,脾内多个稍低密度、强化不明显的结节;肾淋巴瘤8例为肾脏增大,多发软组织结节,无肾积水。结论艾滋病相关骨淋巴瘤、肝门区淋巴瘤、脾脏淋巴瘤、颅内淋巴瘤等CT及MRI表现有一定特点;MRI腹腔脏器病灶检出率优于CT,特别是扩散加权成像;此外结内型倍增时间短,肿块巨大并发坏死常见。

Objective To investigate the imaging features of CT and MRI of AIDS patients with lymphoma and im- prove the imaging knowledge of the disease. Methods The CT and MRI manifestations of 108 patients with AIDS merged lymphoma were retrospectively analyzed. Results Of the 108 patients, there were 51 cases with superficial lymph nodes, 38 cases with internal and external disease. The tumor doubling time was short. The tumor often integrated into larger clumps and necrosis in common. There were 11 cases with intracranial disease without obvious peritumoral e- dema deep brain mass. DWI showed high signal or aseptic meningitis. There were 7 cases with small blood vessels through the mass or close to the masses, 5 cases with bone lymphoma showed osteolytic destruction with obvious soft tis- sue mass, 12 cases with liver lymphoma with progressive soft tissue mass, 4 cases with splenic lymphoma splenomegaly, spleen, diffuse slightly low density enhancement nodules and 8 cases wih renal lymphoma in kidney of kidney and soft tis- sue mass. ConcLusion By the imaging of CT and MRI, bone lymphoma, hilar lymphoma, splenic lymphoma, intracranial lymphoma have some characteristics. MRI is superior to CT in diagnosing abdominal Malignant Lymphoma.