原发性胃肠淋巴瘤临床、影像及病理对照研究

Comparative Study of Clinic,Imaging Diagnosis and Pathology of Primary Gastrointestinal Lymphoma

目的探讨原发性胃肠淋巴瘤(PGIL)临床及多层螺旋CT相关特征,提高对其诊断和鉴别诊断能力。方法回顾185例确诊为PGIL患者资料(其中60例有完整影像学资料),分析其病理类型、临床特点及相关影像学特征,并加以归纳,总结诊断经验。结果185例PGIL中以PGL较常见,82.5%PIL及94.8%PGL病理类型均为B细胞源性淋巴瘤,其中又以弥漫大B细胞淋巴瘤及黏膜相关性淋巴瘤最为常见。PGIL临床症状以腹痛为主,多层螺旋CT除了能观察到既往文献报道的"黏膜白线征"、"动脉瘤样扩张征"之外,还能观察到"血管飘浮征"、"刀削征"、"融冰征"及延迟持续强化征象。结论PGIL其临床及影像表现均有一定特点,把握好其细节特征能更好发挥MSCT检查的术前诊断价值。

Objective To investigate the clinical and MSCT features of Primary Gastrointestinal Lymphoma(PGIL),as well as to improve the diagnosis and the level of differential diagnosis.Methods A retrospective analysis was performed of 185 cases of PGIL diagnosed in our hospital’s medical record system(60 of which had complete imaging data).The pathological,clinical and imaging characteristics of the cases were analyzed,and then summarized the diagnostic outcome.Results PGL was the most common type of PGIL in the 185 cases.82.5%of PIL and 94.8%of PGL were B-cell lymphoma,including Diffuse Large B-cell Lymphoma(DLBCL)and Mucosal-associated Lymphoid Tissue(MALT)which were the most common types.The main clinical symptom of PGIL was abdominal pain.PGIL cannot only be observed by the"mucosal white line sign"and"aneurysmal dilatation sign"reported in previous literatures,but also observed by the"vessel floating sign",the"serration sign",the"ice melting sign"and continuously delayed enhancement.Conclusion Primary gastrointestinal lymphoma had certain clinical and imaging features,so understanding its detailed features can play a better role in the preoperative diagnosis of MSCT.