肺粘膜相关淋巴组织淋巴瘤CT特征

CT Features of Pulmonary Mucosa Associated Lymphoid Tissue Lymphoma

目的探讨肺粘膜相关淋巴组织淋巴瘤(MALT)的CT特征。方法回顾分析2013年2月至2019年10月我院经病理证实的9例肺MALT淋巴瘤的临床、CT影像及病理资料,其中6例通过手术切除、2例通过穿刺活检、1例经纤维支气管镜取得病例结果。2例行胸部CT平扫,7例行胸部平扫加增强检查;观察肿瘤的影像表现。结果单发6例,多发3例。肺MALT淋巴瘤CT主要表现为沿支气管血管分布肺段样实变为主,中度强化,常见“空气支气管征”、血管“造影征”、周围网状结节影,罕见胸腔积液及纵隔淋巴结肿大。随访稳定,在一定时间及空间上病灶形态较固定,具有局部疾病史特征,本研究病灶均局限于肺部。免疫组化检查CD20、CD79a均阳性,KI-67较低表达(均<15%)。结论肺MALT淋巴瘤属罕见结外惰性非霍奇金淋巴瘤,CT表现具有一定特征性,病理组织学及免疫组化是确诊依据。

Objective To explore the imaging diagnosis of CT in pulmonary mucosa associated lymphoid tissue lymphoma.Methods Nine patients with pulmonary mucosa associated lymphoid tissue lymphoma confirmed by pathology were enrolled during February 2013 to October 2019,and their clinical features,images and pathologic findings were reviewed.Of the 9 cases,6 cases were gained by surgical resection,2 cases by puncture biopsy,and one case by fiberoptic bronchoscopy for pathology.Chest CT plain scan was performed in 2 cases,and chest plain scan and enhanced scan were performed in 7 cases.The imaging features was observed.Results Pulmonary mucosa associated lymphoid tissue lymphoma were solitary in 6 patients and multiple in 3 patients.CT findings is mainly characterized by pulmonary segmental consolidation along bronchial and vessels.The enhanced scan showed moderate enhancement.Air bronchogram,angiography sign,peripheral reticular nodule shadow are common,pleural effusion and lymph node swelling rare.Follow-up was stable.The lesion morphology was relatively fixed in a certain time and space,and had local disease history.In this study,the lesions were all confined to the lungs.Immunohistochemical examination showed that CD20 and CD79a were both positive and kI-67 labeling index was relatively low(both<15%).Conclusion Pulmonary MALT lymphoma is a rare extranodal inert non-Hodgkin lymphoma.CT findings have certain characteristics,and histopathology and immunohistochemistry are the basis of diagnosis.