单中心型Castleman病的CT、MRI表现分析

CT and MR imaging findings of unicentric castleman disease

目的探讨单中心型Castleman病(unicentric castleman disease,UCD)的CT、MRI表现,以提高本病影像学诊断水平。方法回顾性分析46例病理证实的UCD患者的临床及CT、MRI表现。结果本组透明血管型39例,浆细胞型5例,混合型2例;病灶位于颈胸部10例,腹部30例,盆部6例;CT多表现为明显强化的肿块;位于腹膜后者常见边缘模糊并伴有腹膜增厚;本组41%病灶伴有钙化,包括透明血管型和浆细胞型;相较于透明血管型UCD多样的钙化形态,浆细胞型均表现为点状钙化;部分病灶内可见小片状出血、囊变及纤维信号,MRI对这些征象的显示具有优势。结论本组UCD病灶多位于腹部,影像表现与病灶位置及病理类型相关,钙化、纤维成分等具有诊断价值。

Objective To improve radiology diagnosis level of uicentric castleman disease(UCD)by discussing CT and MR imaging findings.Methods Clinical features,CT and MR manifestations in 46 cases of unicentric castleman cisease pathologically confirmed were analyzed retrospectively.Results There were 39 cases of hyaline-vascular type,5 cases of plasmacytic type and 2 cases of mixed type in our study.10 lesions were located in the neck or chest,30 in the abdomen,and 6 in the pelvis.Most of the lesions were characterized by soft tissue mass with marked enhancement.The margin of lesions located in the retroperitoneum was mostly indistinct and peritoneal wrapped.In our study,calcification was found in 41%of lesions,including hyaline-vascular type and plasmacytic type.The calcification in plasmacytic type was found isolated and punctate,in contrast to various shapes in hyaline-vascular type.Magnetic resonance was more advantageous for the observation of focal hemorrhage,cysts and fibrous components inside the lesion.Conclusion According to our research,UCD lesions are mostly located in the abdomen,while the imaging findings are related to pathological type and the location of the lesion.Calcification and fibrous components may be valuable for diagnosis.