Yu Ri-Sheng, Zhang Wei-Min, Liu Yi-Qing
Department of Radiology, Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou 310009, Zhejiang Province, China.
World J Gastroenterol. 2006 Dec 28;12(48):7869-73. doi: 10.3748/wjg.v12.i48.7869.
To assess CT manifestations and its diagnostic value for lymphoma in the abdominal lymph nodes (LALN).
CT findings in 52 cases of LALN proved by surgery or biopsy, including Hodgkin's disease (HD) in 16 cases and non-Hodgkin's lymphoma (NHL) in 36 cases, were retrospectively analyzed.
(1) CT manifestations based on distribution of the lesions of LALN: Solitary mass type was found in 10 cases, including solitary, round, uniform-density, enlarged lymph nodes in 3 cases; and multiple, enlarged lymph nodes fusing into singular lobular mass in 7 cases. Thirty-four cases of multiple-nodular type showed multiple, round, enlarged lymph nodes with uniform density and clear margins. Vessels-embedded signs, including mesenteric vessels, renal vessels, abdominal aorta or inferior vena cava, were seen in 6 cases, and duodenum-embedded signs were seen in 2 cases. Eight cases of diffuse type showed characteristic "cobblestone signs". (2) CT manifestations correlated with pathological type: CT manifestations of 12 cases of HD were different from those of 40 cases of NHL in distribution, size, quantity and fused lesion of enlarged lymph nodes. (3) Twenty-eight cases of 52 patients were accompanied with extra-nodal lymphoma in the abdomen, especially gastrointestinal lymphoma, which had characteristic CT findings. (4) In follow-up examinations, CT images showed uniform, heterogeneous or rim enhancement in 15 cases, and occasional calcifications accompanied with reduction of the lesion size and quantity in 12 cases, whereas the lesions disappeared in 3 cases after treatment.
CT images show many characteristic manifestations valuable for qualitative diagnosis of LALN, and it is also helpful for pathological classification of LALN and therapeutic evaluation in follow-up of patients.
评估腹部淋巴结淋巴瘤的CT表现及其诊断价值。
回顾性分析52例经手术或活检证实的腹部淋巴结淋巴瘤的CT表现,其中霍奇金病(HD)16例,非霍奇金淋巴瘤(NHL)36例。
(1)基于腹部淋巴结病变分布的CT表现:孤立肿块型10例,其中3例为孤立、圆形、密度均匀的肿大淋巴结;7例为多个肿大淋巴结融合成单个分叶状肿块。多结节型34例,表现为多个圆形肿大淋巴结,密度均匀,边缘清晰。6例可见血管包埋征,包括肠系膜血管、肾血管、腹主动脉或下腔静脉;2例可见十二指肠包埋征。弥漫型8例表现为特征性的“鹅卵石征”。(2)CT表现与病理类型相关:12例HD的CT表现与40例NHL在肿大淋巴结的分布、大小、数量及融合病变方面不同。(3)52例患者中有28例伴有腹部结外淋巴瘤,尤其是胃肠道淋巴瘤,具有特征性CT表现。(4)在随访检查中,15例CT图像表现为均匀、不均匀或边缘强化,12例偶尔有钙化,同时病变大小和数量减少,3例治疗后病变消失。
CT图像显示出许多对腹部淋巴结淋巴瘤定性诊断有价值的特征性表现,也有助于腹部淋巴结淋巴瘤的病理分类及患者随访中的治疗评估。