肝脏原发淋巴瘤的影像学表现及误诊分析

Imaging findings and misdiagnosis of primary hepatic lymphoma of liver

目的探讨肝原发淋巴瘤(PHL)的CT和MRI表现,提高对其认识。方法收集10例经穿刺活检或手术证实为原发性肝淋巴瘤的病例。CT检查7例,MRI检查3例,并分析其CT和MRI表现。结果在10例原发性肝淋巴瘤中(3例单发,7例多发),CT和MRI可显示肝内结节及肿块数目及分布,病灶密度/信号可均匀或不均匀,增强扫描后病灶不强化,轻度强化或边缘强化。结论原发性肝淋巴瘤的CT和MRI表现具有一定特征性,但是无特异性影像学表现。当CT和MRI表现为肝内占位性病变,而非原发性肝癌及肝血管瘤的典型影像学表现及实验室检查时,或图像类似肝转移瘤而无原发肿瘤存在时,应注意与之鉴别。

Objective To improve CT and MRI realization of primary hepatic lymphoma（ PHL）. Methods Ten cases of PHL proved pathologically by biopsy and operation were collected,7 patients received CT examinations,and 3 received MRI examinations. The CT and MRI findings were analysed. Results In all of the ten cases,3 cases were single lesion,7 cases were multiple lesions. CT and MRI scan show the number and distribution of the intrahepatic mass lesion in primary hepatic lymphoma. Enhanced CT showed no evident enhancement/mild enhancemant or rim enhancement.Conclusion PHL have no specific imaging findings in CT and MRI,when the CT and MRI shows intrahepatic space-occupying lesions,rather than the typical primary liver cancer and liver hemangioma imaging findings and laboratory tests,or similar liver metastases and no tumor,we should pay close attention to the diagnosis.