肺黏膜相关淋巴组织淋巴瘤的影像特征分析

Imaging characterization of pulmonary mucosa-associated lymphoid tissue lymphoma

目的分析肺黏膜相关淋巴组织淋巴瘤(pulmonary mucosa-associated lymphoid tissue lymphoma,PMALT)的影像学特征。方法收集2017年3月至2024年3月经病理确诊的PMALT患者资料,观察胸部CT上病灶的部位、形态、数量、密度、强化情况等特征。接受全身PET-CT检查的患者,记录病灶的最大标准摄取值(maximum of standard uptake value,SUVmax)。结果共纳入16例PMALT患者,11例(68.75%)为双肺多发病灶;有9例(56.25%)患者病灶密度均匀,病灶跨叶者10例(62.50%),14例(87.50%)患者病灶沿支气管血管束分布且边缘模糊。共收集到病灶数量82个,其中外周型病灶70个(85.37%),分布以左上(32.93%)、右上(24.39%)居多,多为渗出实变型病灶(90.23%);62个(75.60%)具有支气管充气征。有7例(43.75%)伴支气管扩张。11例患者行胸部增强CT扫描,3例(27.27%)轻度强化,6例(54.55%)中度强化,9例(81.82%)存在血管造影征。10例患者行PET-CT扫描,SUVmax范围1.0~11.8。结论PMALT胸部CT双肺多发病灶居多,多为跨叶外周病灶,常沿支气管血管束分布且边缘模糊,形态以渗出实变型病灶为主,常有空气支气管征、支气管扩张征等表现,增强扫描轻中度均匀强化为主,多有血管造影征,PET-CT呈高代谢。

Objective To analyze the imaging features of pulmonary mucosa-associated lymphoid tissue lymphoma(PMALT).Methods The data of patients with PMALT diagnosed by pathology in the First People′s Hospital of Changzhou City from March 2017 to March 2024 were collected,and the characteristics of the lesions on chest CT such as location,morphology,number,density,and enhancement were observed.For patients who underwent whole-body PET-CT,the maximum of standard uptake value(SUVmax)of the lesions was recorded.Results A total of 16 patients with PMALT were included in this study.11 cases(68.75%)had multiple lesions in both lungs,9(56.25%)had homogeneous lesion densities,10(62.50%)had translobular lesions,and 14(87.50%)had lesions that were distributed along the bronchial vascular bundles with blurred edges.A total of 82 lesions were collected,70(85.37%)of which were peripheral-type lesions,distributed mostly in the upper left(32.93%)and upper right(24.39%),and most of them were exudative solid lesions(90.23%).62(75.60%)had bronchial congestion signs.There were 7 cases(43.75%)with bronchial dilatation.11 patients underwent enhanced CT scan of the chest,3(27.27%)with mild enhancement,6(54.55%)with moderate enhancement,and 9(81.82%)with angiographic signs.10 patients underwent PET-CT scan,and SUVmax ranged from 1.0 to 11.8.Conclusion Multiple foci of bilobar pulmonary lesions are predominant in PMALT chest CT.The majority of the foci in PMALT chest CT are peripheral foci,often distributing along the bronchial vascular bundles with blurred edges,and the morphology is dominated by exudative solid foci,often with air bronchial sign and bronchodilatation sign,etc.The enhancement scans show mild to moderate homogeneous enhancement,and there are mostly angiographic signs,and the PET-CT shows high metabolism.