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[颈胸交界区淋巴样肿瘤的多层螺旋CT特征及解剖病理学基础]

[MDCT features and anatomic-pathological basis of lymphoid neoplasm in cervico-thoracic junctional region].

作者信息

Ye Yilan, Yang Zhigang, Shao Heng, Cheng Jing, Tang Sisi, Wen Lingyi

机构信息

Department of Radiology, 452nd Hospital of PLA, Chengdu 610021, China.

出版信息

Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2012 Aug;29(4):624-8.

Abstract

To determine the relevance between MDCT features and anatomic-pathological basis of lymphoid neoplasm in cervico-thoracic junctional region, we performed a retrospective analysis of 69 patients with lymphoid neoplasm (lymphoma: 41 patients; metastatic tumor: 28 patients) involving the cervico-thoracic junctional region for MDCT features and distribution of lesions. The relevance between MDCT features and the anatomic-pathological basis in this region were evaluated. Among all the 41 patients with lymphoma, 29 with NHL (70.7%), 12 with HD (29.3%). The lymphomatous lymphadenopathy mainly located in superficial lateral cervix (51.2%, 21/41) ,deep jugular chain (65.9%, 27/41), supraclavicular fossa (75.6%, 31/41), paratrachea space in anterior mediastinum (46.3%, 19/41), around aortic arch (56.1%, 23/41), aortopulmonary window (53.7%, 22/41), upper anterior mediastinum (41.5%, 17/41), subcarinal space (26.8%, 11/41) and paraesophageal space (17.1%, 7/41). 28 patients had metastatic lymphoid tumor. The primary tumor were nasopharynx tumor (5 patients), thyroid cancer (7 patients), lung cancer (10 patients), and esophageal cancer (6 patients). Most metastasis took stage by stage in the way of lymphatic return, but a minority of cases migrated jumpily. The main metastatic sites were: beside jugular chain (82.1%), supraclavicular fossa (75%), paratracheal in anterior mediastinum (60.7%), upper anterior mediastinum (64.3%), beside aortic arch (35.7%), aortopulmonary window (39.2%), and paraesophageal space (28.6%). So lymphoid neoplasms in cervico-thoracic junctional region were involving both lower cervix and upper thorax simultaneously. The MDCT features and main distribution of lesions correlated with the anatomic-pathological characteristics in this region.

摘要

为了确定颈胸交界区淋巴样肿瘤的MDCT特征与解剖病理基础之间的相关性,我们对69例累及颈胸交界区的淋巴样肿瘤(淋巴瘤41例;转移性肿瘤28例)患者的MDCT特征及病变分布进行了回顾性分析。评估了MDCT特征与该区域解剖病理基础之间的相关性。在41例淋巴瘤患者中,29例为非霍奇金淋巴瘤(NHL,70.7%),12例为霍奇金淋巴瘤(HD,29.3%)。淋巴瘤性淋巴结肿大主要位于颈外侧浅部(51.2%,21/41)、颈深链(65.9%,27/41)、锁骨上窝(75.6%,31/41)、前纵隔气管旁间隙(46.3%,19/41)、主动脉弓周围(56.1%,23/41)、主动脉肺动脉窗(53.7%,22/41)、上纵隔前部(41.5%,17/41)、隆突下间隙(26.8%,11/41)和食管旁间隙(17.1%,7/41)。28例患者有转移性淋巴样肿瘤。原发肿瘤为鼻咽癌(5例)、甲状腺癌(7例)、肺癌(10例)和食管癌(6例)。大多数转移以淋巴回流的方式逐站进行,但少数病例呈跳跃式转移。主要转移部位为:颈链旁(82.1%)、锁骨上窝(75%)、前纵隔气管旁(60.7%)、上纵隔前部(64.3%)、主动脉弓旁(35.7%)、主动脉肺动脉窗(39.2%)和食管旁间隙(28.6%)。因此,颈胸交界区的淋巴样肿瘤同时累及下颈部和上胸部。MDCT特征及病变主要分布与该区域的解剖病理特征相关。

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