原发性肠道T细胞淋巴瘤CT小肠造影的影像特点及其诊断价值

Diagnostic value and characteristics of CT enterography in primary intestinal T-cell lymphoma

目的分析原发性肠道T细胞淋巴瘤(PITCL)CT小肠造影(CTE)的影像学特点及诊断价值。方法回顾性分析18例经手术及病理确诊的PITCL患者的CTE表现,总结其病变部位、数目、强化方式、淋巴结肿大及其他脏器受累情况、并发症等。结果 18例PITCL中,多发13例(13/18,72.22%),单发5例(5/18,27.78%);发生于空肠/回肠12例,其中3例同时累及结肠,仅发生于结肠5例,仅发生于十二指肠1例;发生肠穿孔6例。根据其CT表现分为6型:浸润型(7例)、弥漫性回肠空肠化型(3例)、肠腔瘤样扩张型(3例)、息肉肿块型(2例)、肠系膜型(1例)、混合型(2例)。结论CTE可清晰显示PITCL的影像学特点,对肠道T细胞淋巴瘤的诊断有重要价值。

Objective To evaluate the manifestations and diagnostic value of CT enterography （CTE） in primary intestinal T-cell lymphoma （PITCL）. Methods Eighteen patients with PITCL confirmed by pathology were reviewed retrospectively. The characteristics of lesion site, amount of foci, pattern and degree of contrast enhancement, lymphadenopathy, involvement of other organs and complications were recorded. Results In all of the 18 patients with PITCL, multiple lesions were seen in 13 cases （13/18, 72.22%）, and solitary involvement was seen in 5 cases （5/18, 27.78%）. Twelve cases were located at jejunum/ileum, 3 of them were also involved in the colon. Five cases were located only in the colon, and 1 in the duodenum. Six cases were complicated with intestinal perforation. The patients were categorized into 6 types according to the CT manifestation： infiltration type （n=7）, diffuse jejunum mucosa ileum metaplasia type （n=3）, luminal aneurismal dilatation type （n=3）, polypoid mass type （n=2）, mesentery type （n=1）, mixed type （n=2）. Conclusion CTE can clearly display the imaging of PITCL and it has high value for the diagnosis of PITCL.