类肿瘤样腹部非血源性播散性结核性淋巴结病：12 例 CT 评估及文献复习。
Neoplasm-like abdominal nonhematogenous disseminated tuberculous lymphadenopathy: CT evaluation of 12 cases and literature review.
机构信息
Department of Medical Imaging, First Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an 710061, Shaanxi Province, China.
出版信息
World J Gastroenterol. 2011 Sep 21;17(35):4038-43. doi: 10.3748/wjg.v17.i35.4038.
AIM
To assess the diagnostic value of computed tomography (CT) imaging in screening for abdominal nonhematogenous disseminated tuberculous lymphadenopathy (TL).
METHODS
The CT scans of 12 patients with abdominal nonhematogenous disseminated TL suggestive of neoplasm were retrospectively analyzed in this review. The final diagnoses were confirmed by lymph node pathology for seven patients and by laparoscopic surgery for five patients. All of the patients were treated at our institution between April 1995 and August 2009.
RESULTS
The sites of involvement were the periportal (n = 6), peripancreatic (n = 3), periaortic (n = 3), and mesenteric (n = 2) regions. On the plain CT scan, the lymphadenopathy showed a heterogeneous isodensity or hypodensity in 11 patients and a low density in one patient. Peripheral enhancement was observed on the dynamic contrast-enhanced CT scans for all patients. In two cases, scans were more revealing during the portal venous and delayed phases.
CONCLUSION
Abdominal lymphadenopathy with predominant peripheral rim-like enhancement on the dynamic contrast-enhanced CT scan may suggest a diagnosis of TL.
目的
评估计算机断层扫描（CT）成像在筛查腹部非血源性播散性结核性淋巴结病（TL）中的诊断价值。
方法
本回顾性研究分析了 12 例疑似肿瘤的腹部非血源性播散性 TL 的 CT 扫描。7 例患者的最终诊断通过淋巴结病理证实，5 例患者通过腹腔镜手术证实。所有患者均于 1995 年 4 月至 2009 年 8 月在我院接受治疗。
结果
受累部位为门静脉周围（n = 6）、胰周（n = 3）、主动脉旁（n = 3）和肠系膜（n = 2）区域。在平扫 CT 扫描中，11 例淋巴结病呈异质性等密度或低密度，1 例呈低密度。所有患者的动态增强 CT 扫描均可见外周强化。在 2 例病例中，门静脉期和延迟期扫描显示更清晰。
结论
腹部淋巴结病在动态增强 CT 扫描上表现为主要的外周边缘样强化，可能提示 TL 的诊断。
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