鼻咽部淋巴瘤与鼻咽癌的MR表现及误诊分析

MR Findings and Misdiagnosis of Nasopharyngeal Lymphoma and Nasopharyngeal Carcinoma

目的:探讨鼻咽部淋巴瘤(NPL)的MRI表现特点及误诊病例分析,并与鼻咽癌鉴别。方法:回顾性分析经病理证实的7例鼻咽部淋巴瘤(NPL)和12例鼻咽癌(NPC)的MRI资料,所有病例均进行了MRI常规平扫及增强检查。结果:19例患者均表现为鼻咽部肿物,双侧颈部多发淋巴结肿大;其中7例鼻咽部淋巴瘤病灶呈双侧对称侵犯或位置居中者6例,病灶表浅且呈弥漫性累及鼻咽腔韦氏环、口咽、扁桃体者5例,邻近骨质受侵者1例;12例鼻咽癌病例中有10例表现为偏侧侵犯,7例出现蝶窦、斜坡、颅底骨质破坏。结论:MRI能够清晰显示鼻咽部淋巴瘤的位置及范围,诊断上应注意与鼻咽癌相鉴别。

Purpose: To investigate the MRI features of nasopharyngeal lymphoma(NPL) and identify it from nasopharyngeal carcinoma. Methods: The MRI findings of 7 cases of nasopharyngeal lymphoma(NPL) and 12 cases of nasopharyngeal carcinoma( NPC) confirmed by pathology results were retrospectively analyzed. All patients were examined with plain and enhanced MRI scan. The image data were assessed for tumour distribution, appearance and local tumour invasion. Results: All the 19 cases showed mass in nasopharynx region and cervical lymph node metastasis, 6 cases of NPL were bilaterally symmetrically invaded or centrally located, 5 cases were superficial and diffusely involved, including the invasion of Waldeyer’s ring, oropharynx and nasal cavity. Bony erosion in skull base was presented in 1 cases.Ten cases of NPC were asymmetrically located, 7 cases showed bony erosion of sphenoid sinus. Conclusion: MRI imaging can clearly display the location, shape and scope of nasopharyngeal lymphoma that commonly depicted as a symmetrical and diffuse mass in nasopharynx. While NPC is comparatively localized asymmetrically, with deeply involvement and bony erosion.