胸腺黏膜相关淋巴组织结外边缘区淋巴瘤的CT表现

CT findings of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue of thymus

目的 :探讨胸腺黏膜相关淋巴组织结外边缘区(MALT)淋巴瘤的CT表现,以提高对该病的认识。方法 :回顾性分析7例经手术病理证实的胸腺MALT淋巴瘤的临床及影像资料。7例均行CT平扫加增强扫描。结果:7例中5例伴自身免疫性疾病,其中4例伴干燥综合征。7例病灶均位于前纵隔胸腺区,均呈单侧性生长,病灶边界清晰,5例边缘规则;7例病灶均呈实性软组织密度,其中6例密度不均伴小囊样低密度灶,但均未见出血或钙化灶,增强扫描实性成分呈中度以上强化,但病灶内小囊样低密度灶未见明显强化。7例病灶均未突破包膜向邻近组织和血管结构侵犯。1例病灶内可见小血管影。1例病灶局部有血管包绕,但无挤压和侵犯倾向。7例纵隔及纵隔外均未见明显肿大淋巴结。结论:CT表现在胸腺MALT淋巴瘤诊断中具有一定价值,再结合胸腺MALT淋巴瘤与自身免疫性疾病(干燥综合征最多见)密切相关这一特点,有助于提高诊断准确性。

Objective:To investigate the CT manifestations of extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue(MALT) of the thymus and improve the understanding of the disease. Methods:The clinical data of 7 patients of thymic MALT lymphoma confirmed by clinical pathology were retrospectively analyzed. All 7 patients underwent plain CT and enhanced CT. Results:Most of the 7 patients were middle-aged women. 5 cases were associated with autoimmune diseases,4 cases with Sjogren’s syndrome. CT examination showed that the lesions in all 7 patients were located in the anterior mediastinal thymus region with unilateral growth. 7 lesions had clear boundaries,and most of them were regular. All 7 lesions showed solid soft tissue density,and 6 of them had uneven density with cystic hypodensity foci,without bleeding or calcification. After enhancement,solid components showed moderate or severe enhancement,but no obvious enhancement was observed in cystic hypodensity foci within the lesion. In 7 cases,the lesions did not breach the capsule and invade the adjacent tissues and vascular structures. A small vascular shadow was observed in 1 case. 1 case had local vascular wrapping,but no compression or invasion tendency.There were no obvious enlarged lymph nodes inside or outside the mediastinum in 7 patients. Conclusions:CT findings have certain value in the diagnosis of thymus MALT lymphoma,and in consideration of its close correlation with autoimmune diseases(Sjogren’s syndrome is the most common),it is helpful to improve the diagnostic accuracy of this disease.