11例原发性肺淋巴瘤的CT特征性表现

CT manifestations and pathologic features of primary pulmonary lymphoma

目的:探讨原发性肺淋巴瘤的CT表现及对应的病理特点,提高对其的认识及诊断率。方法:回顾性分析总结我院经临床病理最终证实的11例原发性肺淋巴瘤的胸部CT表现及相关临床资料。结果:CT平扫有6例为肺结节型,3例为肿块型,1例为实变型,1例为间质条索型;伴随征象中有空气支气管征8例,病变周围晕征10例,伴有胸腔积液2例;所有病例中又有4例呈跨叶生长,均未见肺门及纵隔淋巴结肿大。11例中有8例行CT增强检查,5例呈较均匀强化,3例不均匀强化;其中有2例可见血管造影征。最终病理结果为黏膜相关性淋巴瘤9例,弥漫性大B细胞性淋巴瘤2例。结论:原发性肺淋巴瘤CT表现无明显特异性,与病理分型有一定相关性,空气支气管征、病变周围晕征、血管造影征、跨叶生长、无肺门/纵隔淋巴结肿大,对原发性肺淋巴瘤的诊断有重要提示价值。

Objective:To investigate the CT manifestations and pathologic features of primary pulmonary lymphoma(PPL)in order to improve its diagnosis rate.Method:The chest CT and clinical data of 11 cases of PPL proved by pathology in our hospital were analyzed retrospectively.Results: There were 6 cases of pulmonary nodular type,3 cases of mass type,1 case of solid degeneration type,1 case of interstitial stripe type,and 8 cases of air bronchogram sign,10 cases of halo sign and 2 cases of pleural effusion.In all cases,4 cases showed cross-leaf growth and no enlargement of hilar and mediastinal lymph nodes were seen.CT enhancement scan was performed in 8 of 11 cases,5 cases showed homogeneous enhancement,and 3 cases showed uneven enhancement.Among 8 cases,2 cases showed angiography spot sign.The final pathological results were mucosa-associated lymphoma in 9 cases and diffuse large B-cell lymphoma in 2 cases.Conclusions:CT manifestations of PPL are not specific,and are correlated with pathological classification.Air bronchogram sign,peripheral halo sign,angiographic spot sign,cross-leaf growth,and absence of hilar/mediastinal lymph node enlargement are important indications for diagnosis of PPL.