原發性結外淋巴瘤的多模態影像檢查分析及價值探討

目的：探討原發性結外淋巴瘤影像學多模態的診斷價值。方法：回顧性分析37例經病理證實的原發性結外淋巴瘤在CT，MRI及18F-FDGPET/CT的表現。結果：37例患者中胃淋巴瘤佔7例，腸淋巴瘤7例，頸部包括Waldyer環、鼻腔、舌、涎腺等佔8例，腦部、軟組織分別各3例，骨骼2例，腎上腺、腎上腺及睪丸、輸尿管、前列腺及精囊腺、脾臟及肝臟、肺部、皮膚各佔1例。全部病例為非霍傑金淋巴瘤，最常見的組織學亞型為B細胞淋巴瘤（24/37,64.8%），其次為T細胞淋巴瘤（3/37,8.1%）。CT表現為中等或稍低密度腫塊，密度均勻；MRI示T1WI為等或稍低信號，T2WI為等或稍高信號，DWI示彌散受限，增強後多為中度均勻強化，壞死少見。18F-FDGPET/CT除顯示CT特點，病灶攝取18F-FDG明顯增高，呈結節或團片狀放射性濃聚。結外淋巴瘤常可見臟器原有解剖形態結構殘留。結論：原發性結外淋巴瘤在影像表現上有一定特徵性，影像學多模態檢查能夠提高診斷準確率。

關鍵字

淋巴瘤；計算機體層成像；磁共振成像； 18F-FDG PET/CT

並列摘要

Objective: To evaluate the diagnostic value of multimodal imaging for primary extranodal lymphoma. Methods: 37 cases of primary extranodal lymphoma confirmed by pathology were analyzed retrospectively. Results: 37 patients of primary extranodal lymphoma included 7 cases in the stomach, 7 in the small intestine, 8 in the cervical area including Waldeyer's ring, nasal cavity, tongue, and salivary gland, 3 in head and soft-tissue respectively, 2 in bone, 1 case each for adrenal, adrenal and testicle, ureter, prostate and seminal vesicle, liver, and spleen, lung, skin respectively. All cases were non-Hodgkin's lymphoma and the most common histological subtypes were large B-cell lymphoma(24/37, 64.8%) and T-cell lymphoma(3/37, 8.1%). CT examination showed homogeneous isodensity or subtle hypodensity. MRI examination demonstrated uniform isointensity or mild hypointensity signal on T1WI, iso to mild hyperintensity signal on T2WI, moderate homogeneous enhancement and restricted diffusion. The lesion uptake of 18F-FDG was significantly higher, showed nodular or mass radioactive concentration. Extranodal lymphoma usually remained an intrinsic organ structure. Conclusion: The imaging features of extranodal lymphoma have some typical characteristics. CT, MRI combined with 18F-FDG PET-CT may improve diagnostic accuracy.

並列關鍵字

Lymphoma ； CT ； MRI ； 18F-FDG PET/CT

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