腹部局灶型Castleman’s病的CT表现与病理学分析

CT features and pathological analysis of the abdominal focal type Castleman's disease

目的探讨局灶型Castleman’s病(LCD)的CT表现及病理学基础。方法回顾性分析我院经手术病理证实的8例LCD的CT及病理学资料。结果混合型1例,呈均匀软组织密度,透明血管型7例,呈不均匀软组织密度,病灶内含丰富增生的小血管,增强动脉期呈明显高度强化,静脉期及延迟期仍持续中高强化.6例病灶内可见纤维瘢痕,CT上表现为放射状或分支状低密度影,增强延迟期范围逐渐缩小;2例病灶内可见变性血管壁的钙化影,1例病灶内见多发囊变影,增强无强化。5例病灶周围伴多发肿大淋巴结,病理为慢性反应性淋巴结炎。5例病灶周围见增粗血管影环绕。结论腹部LCD的CT表现具有一定的特征性,肿块内组织成分的多样性及其比例的不同是导致肿块CT表现多样的重要因素。

Objective To evaluate the CT findings and pathological basis of focal type Castleman’s disease(LCD).Methods The CT and pathological data of 8cases of LCD,which were confirmed by operation and pathology in my hospital,were retrospectively analyzed.Results Of those 8cases,1case was mixed type,which showed homogeneous soft tissue density and 7cases were the hyaline vascular type,which showed inhomogeneous soft tissue density containing abundant small vessel hyperplasia lesions.At the enhanced arterial phase,the lesions were highly enhanced and were highly strengthened continuously at venous and delayed phases.6cases had fibrous scar,which was radial or branched low density in CT performance and was gradually narrowing the scope in enhanced delay period.Calcification within the lesion of degenerated vascular wall was seen in 2cases.And multiple cystic shadows were seen in the lesion in 1case,which were not enhanced on contrast-enhancement.5cases had multiple enlarged lymph nodes around the lesions,which were confirmed as chronic reactive lymphadenitis by pathology.5cases were found the lesions surrounding with the dilated blood vessel shadows.Conclusion CT performance of abdominal LCD has certain characteristics.The diversity of tissue components within the tumorsand different proportion are important factors,which are attributable to the multiple manifestations of masses on CT.