巨淋巴结增生症的影像学表现及病理分析

Imaging findings and pathological analysis of giant lymph node hyperplasia

目的:探讨巨淋巴结增生症的影像学及病理表现,旨在提高对本病的诊断水平。方法:回顾性分析2015-06-01~2019-07-01于我院诊治的10例巨淋巴结增生症患者的临床及影像学资料,所有病例均经手术病理证实,术前均行CT、MR平扫及增强扫描。结果:10例患者中病灶位于纵隔、腹部各3例,颈部4例。病理结果显示9例为透明血管型,1例为浆细胞型。所有病灶在CT及MR上均表现为边界清楚、密度或信号均匀的圆形或类圆形肿块,其中1例CT平扫病灶中心见钙化。10例患者MR平扫均表现为T1等低信号,T2稍高信号,其中4例病灶中心见裂隙样低信号影,2例病灶周围可见迂曲走行的流空血管影。增强扫描后,9例患者增强早期均表现为明显强化,仅1例为轻度强化,延迟期均持续强化。结论:巨淋巴结增生症以透明血管型为主,影像学表现具有特征性,其持续强化的增强模式和病理特征相关联,对该病的诊断与鉴别诊断具有重要价值。

Objective:To explore the imaging and pathological findings of giant lymph node hyperplasia,in order to improve the diagnosis level of this disease.Methods:The clinical and imaging data of 10 cases with giant lymph node hyperplasia from June 2015 to July 2019 were retrospectively analyzed.All cases were confirmed by operation and pathology.CT and MR were performed before operation.Results:Among the 10 patients,lesions located in the mediastinum and abdomen were 3 cases,respectively.And 4 cases in the neck.Pathology showed 9 cases were hyaline vascular type and 1 case was plasma cell type.All lesions showed a round or round-like mass with clear boundary,density or signal uniformity on both CT and MR.One of the CT showed calcification at the center of the lesion.The MR of 10 cases showed low signal such as T1 and slightly higher signal of T2.Among them,4 cases showed crack-like lowsignal shadows in the center of the lesion,and 2 cases of lesions showed distorted vascular shadows around the lesion.After the enhanced scan,9 patients showed significant enhancement in the early stage of enhancement,only 1 case was mildly enhanced,and the delayed period continued to strengthen.Conclusion:Giant lymph node hyperplasia is mainly composed of hyaline vascular type.Its imaging findings are characteristic,enhanced pattern and pathological features has great value in the diagnosis and differential diagnosis of this disease.