Ivancev K, Halldorsdottir A, Laurin S, Sandström S, Békássy A, Garwics S, Wiebe T
Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
Acta Radiol. 1988 Jan-Feb;29(1):115-20.
Thirty-one children with mediastinal abnormalities--14 malignant lymphomas, 4 other primary malignancies, one metastatic and 12 benign lesions--were examined one or several times using CT, which proved to be effective especially for cysts (5 patients), ductus arteriosus aneurysm (2 patients), and intrathoracic liver (one patient). It also supplied important diagnostic information regarding the extent of disease in malignant thymoma (one patient), in neurinoma (one patient), and in Hodgkin's lymphoma (5 patients). It was found to be useful in the monitoring of treatment of patients with lymphomas, in which a small residue, probably a fibrotic remnant, was invariably seen after completion of chemotherapy and irradiation. It was concluded that when the residue was enlarged, the possibility of relapse and even thymic hyperplasia should be considered. However, if CT was performed under general anaesthesia pseudo-widening of the anterior mediastinum could simulate recurrence. Surgical biopsy was found to be necessary in these cases because fine-needle aspiration biopsy was unsuccessful.
31例纵隔异常患儿——14例恶性淋巴瘤、4例其他原发性恶性肿瘤、1例转移瘤和12例良性病变——接受了1次或多次CT检查，结果证明CT对囊肿（5例）、动脉导管瘤（2例）和胸腔内肝脏（1例）特别有效。它还提供了有关恶性胸腺瘤（1例）、神经鞘瘤（1例）和霍奇金淋巴瘤（5例）疾病范围的重要诊断信息。发现CT对淋巴瘤患者的治疗监测有用，化疗和放疗结束后总是能看到一个小残留，可能是纤维化残余物。得出的结论是，当残留增大时，应考虑复发甚至胸腺增生的可能性。然而，如果在全身麻醉下进行CT检查，前纵隔的假性增宽可能会模拟复发。在这些情况下，由于细针穿刺活检不成功，发现手术活检是必要的。
