Burgener F A, Hamlin D J
Cancer. 1981 Dec 15;48(12):2589-95. doi: 10.1002/1097-0142(19811215)48:12<2589::aid-cncr2820481209>3.0.co;2-m.
Medical records, pathologic records, an radiologic examinations of 112 patients with histiocytic lymphoma (HL) were reviewed. Peripheral lymph node enlargement was initially present in less than 50%, while HL presented as localized intraabdominal or intrathoracic lesions in 29% and 13%, respectively. Diagnostic problems encountered during the radiologic evaluation of patients with HL included the following: 1) Localized intraabdominal and intrathoracic lesions could mimic a variety of diseases, most often carcinoma. 2) Intercurrent (opportunistic) infections, which were commonly found in the lungs, and more rarely in the distal esophagus and bone, could easily be mistaken for HL manifestations. 3) Cytotoxic drugs and/or steroids produced pulmonary infiltrates, gastric ulcers, and collapsed vertebral bodies were often indistinguishable from an HL manifestation. 4) A second malignancy, found in 10% of patients either before or after HL was diagnosed, was difficult to differentiate from HL. 5) Aspiration biopsy of localized intraabdominal or intrathoracic HL under fluoroscopic control was unreliable in establishing the correct diagnosis.
对112例组织细胞性淋巴瘤（HL）患者的病历、病理记录及放射学检查进行了回顾。最初出现外周淋巴结肿大的患者不到50%，而HL分别以29%和13%的比例表现为局限性腹腔内或胸腔内病变。HL患者放射学评估过程中遇到的诊断问题包括以下几点：1）局限性腹腔内和胸腔内病变可能会模仿多种疾病，最常见的是癌。2）并发（机会性）感染在肺部很常见，在远端食管和骨骼中较少见，很容易被误认为是HL的表现。3）细胞毒性药物和/或类固醇导致的肺部浸润、胃溃疡和椎体塌陷通常与HL表现难以区分。4）在10%的患者中，在HL诊断之前或之后发现的第二种恶性肿瘤很难与HL区分开来。5）在透视控制下对局限性腹腔内或胸腔内HL进行穿刺活检在确立正确诊断方面并不可靠。
