髓外浆细胞瘤的CT及MRI表现

CT and MRI Features of Extramedullary Plasmacytoma

目的探讨髓外浆细胞瘤(EMP)的影像特征,以提高对本病的认识。方法回顾性分析22例经病理证实的EMP患者的临床及影像学资料并复习相关文献,总结其CT及MRI特征。结果22例中,16例发生于头颈部(鼻腔鼻窦6例,鼻咽3例,眼眶2例,颅内2例,颌下腺1例,甲状腺1例,喉1例),6例发生于其他部位(胸壁2例,肺内1例,盆腔1例,睾丸1例,椎管内1例)。22例均表现为孤立的软组织肿块,15例密度/信号均匀,2例伴囊变坏死,2例伴钙化,5例DWI高b值弥散受限呈高/稍高信号,12例伴邻近骨质吸收破坏,14例伴周围组织侵犯,增强扫描多呈明显强化,3例肿块内部或周边见迂曲增粗血管影。结论EMP的CT及MRI具有一定特点:病灶多为孤立的软组织肿块,密度/信号均匀,囊变坏死、钙化少见,易侵犯邻近骨质及周围组织,增强扫描呈明显强化,肿块内部或周边可见流空血管影。

Objective To explore the imaging features of extramedullary plasmacytoma(EMP)so as to improve the understanding of this disease.Methods The clinical and imaging data of 22 patients with pathologically confirmed EMP in our hospital were retrospectively analyzed,and the related literature was reviewed.The CT and MRI features were summarized.Results Of the 22 cases,16 occurred in the head and neck:nasal sinus(n=6),nasopharynx(n=3),orbital(n=2),intracranial(n=2),submandibular gland(n=1),thyroid(n=1),larynx(n=1);6 cases occurred in other parts:chest wall(n=2),lung(n=1),pelvic(n=1),testis(n=1),spinal canal(n=1).All the 22 cases showed solitary soft tissue masses,15 cases with homogeneous density or signal,2 cases with necrosis,2 cases with calcification,and 5 cases showed diffusion restriction with slightly and remarkable hyperintense signal on DWI,12 cases with adjacent bone destruction,14 cases with surrounding tissue invasion,enhanced scan showed obvious enhancement,3 cases showed tortuous enlargement of blood vessels in or around the mass.Conclusion There are some characteristics findings of EMP on CT and MRI.The lesions are mostly solitary soft tissue masses,with homogeneous density or signal,cystic necrosis and calcification are rare,easily invade adjacent bone and surrounding tissues,enhanced scanning shows obvious enhancement and high flow vascularity around or within the lesion.