儿童腹部成熟B细胞非霍奇金淋巴瘤CT表现及免疫组化分析

CT Diagnosis of Abdominal Mature B-cell Non-Hodgkin Lymphoma in Children

目的探讨小儿腹部成熟B细胞非霍奇金淋巴瘤CT影像及免疫组化特征。方法回顾性分析17例小儿腹部成熟B细胞非霍奇金淋巴瘤CT表现及免疫组化结果,全部肿瘤经手术病理证实。结果17例均为男孩,年龄3~10岁,中位年龄5岁9月。1例表现为胃壁增厚及肿块;16例肠壁增厚程度不一,其中肠壁中度或明显增厚13例,以肿块为主要表现11例,其中10例直径大于50mm;可有腹膜增厚、肠系膜间隙脂肪密度增高、肠动脉瘤样扩张、夹心面包征、腹腔淋巴结肿大、肠套叠、腹盆腔积液、实质脏器受累、腹外转移等影像表现。肿瘤细胞在免疫组化中常表达CD19、CD20、CD22、CD79a,Bcl-2阴性也是其特征之一。结论儿童腹部成熟B细胞非霍奇金淋巴瘤,具备一定的影像学特点,肠壁增厚、肠区肿块、腹膜系膜弥漫性增厚等,结合免疫组化提示腹部成熟B细胞非霍奇金淋巴瘤。

Objective To investigate the CT and immunohistochemical features of mature abdominal B-cell non-Hodgkin lymphoma in children.Methods CT findings and immunohistochemical findings of 17 cases of abdominal mature B-cell non-Hodgkin lymphoma were retrospectively analyzed.All the tumors were confirmed by operation and pathology.Results All the 17 cases were boys,aged from 3 to 10 years,with a median age of 5 years and 9 months.1 case showed gastric wall thickening and mass;the thickness of intestinal wall varied in 16 cases,including 13 cases with moderate or obvious thickening,11 cases with mass as the main manifestation,10 cases with diameter greater than 50mm;imaging manifestations include peritoneal thickening,increased mesenteric space fat density,intestinal aneurysmal dilatation,sandwich sign,abdominal lymph node enlargement,intussusception,abdominal pelvic effusion,parenchymal organ involvement,and extrabdominal metastasis.Tumor cells often express CD19,CD20,CD22,CD79a in immunohistochemistry,and Bcl-2 negative is also one of its characteristics.Conclusion Mature abdominal B-cell non-Hodgkin lymphoma in children has certain imaging features,such as intestinal wall thickening,intestinal mass,diffuse peritoneal mesangial thickening,etc.Combined with immunohistochemistry,it indicates mature abdominal B-cell non-Hodgkin lymphoma.