Lewis E R, Caskey C I, Fishman E K
Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
AJR Am J Roentgenol. 1991 Apr;156(4):711-4. doi: 10.2214/ajr.156.4.2003430.
Lymphomatous involvement of the lungs is often a difficult clinical and radiologic diagnosis to make, yet is often critical in determining treatment. To better define the CT appearance of pulmonary lymphoma, we undertook a retrospective review of 31 patients with recurrent or secondary non-Hodgkin lymphoma or Hodgkin disease and lung parenchymal involvement on CT scans. Diagnoses were confirmed either by lung biopsy or by disease regression or progression with appropriate therapy. The CT scans were evaluated for the following findings: (1) nodules less than 1 cm, (2) a mass or masslike consolidation greater than 1 cm with or without cavitations or bronchograms, (3) alveolar or interstitial infiltrates, (4) masses of pleural origin, (5) peribronchial or perivascular thickening with or without atelectasis, (6) pleural effusions, and (7) hilar or mediastinal lymphadenopathy. The most common CT finding was a mass or masslike consolidation larger than 1 cm, seen in 21 (68%) of the 31 patients. The second most common finding was nodules less than 1 cm (19 patients). Sixty-eight percent of patients had three or more of the CT abnormalities. Lymphoma involving the lung parenchyma causes a variety of CT findings, the most common being a mass or masslike consolidation. Two-thirds of patients have more than one type of CT finding simultaneously.
肺部淋巴瘤的累及情况往往在临床和影像学上难以诊断，但在确定治疗方案时却常常至关重要。为了更好地明确肺淋巴瘤的CT表现，我们对31例复发性或继发性非霍奇金淋巴瘤或霍奇金病且CT扫描显示肺实质受累的患者进行了回顾性研究。诊断通过肺活检或疾病经适当治疗后的消退或进展得以证实。对CT扫描评估以下表现：（1）直径小于1cm的结节；（2）直径大于1cm的肿块或类肿块实变，伴有或不伴有空洞或支气管造影征；（3）肺泡或间质浸润；（4）胸膜源性肿块；（5）伴或不伴有肺不张的支气管周围或血管周围增厚；（6）胸腔积液；（7）肺门或纵隔淋巴结肿大。最常见的CT表现是直径大于1cm的肿块或类肿块实变，31例患者中有21例（68%）出现此表现。第二常见的表现是直径小于1cm的结节（19例患者）。68%的患者有三种或更多种CT异常表现。累及肺实质的淋巴瘤会导致多种CT表现，最常见的是肿块或类肿块实变。三分之二的患者同时有不止一种类型的CT表现。
