原发性非霍奇金脾脏淋巴瘤
Primary non-Hodgkin's splenic lymphoma.
作者信息
Dachman A H, Buck J L, Krishnan J, Aguilera N S, Buetow P C
机构信息
Department of Radiology, The University of Chicago, IL 60637, USA.
出版信息
Clin Radiol. 1998 Feb;53(2):137-42. doi: 10.1016/s0009-9260(98)80061-5.
OBJECTIVES
To describe the imaging, clinical and pathological features of primary splenic lymphoma using a strict definition.
METHODS
Of 21 cases, plain films were available in nine, sonograms in 10 and CT in 16. We categorized the spleen as either normal, enlarged with no focal defects (type 1), studded with miliary masses (type 2), containing multifocal masses of varying size (1-10 cm) (type 3) or containing a solitary large mass >5 cm without (type 4A) or with (type 4B) central hypodensity/anechoic areas.
RESULTS
Clinical presentations were left upper quadrant pain, weight loss and/or fever. One case was found incidentally on CT. Fourteen were type 4A, three type 4B, four type 3 and none were type 1 or 2. Nine of 10 cases were hypoechoic. In 11/12 cases with enhanced scans, the lesions are hypodense relative to the splenic parenchyma, and in one case, the lesion was necrotic. Rim enhancement was seen in one case.
CONCLUSION
Primary splenic lymphoma usually presents as a mass or masses rather than with splenomegaly alone. Splenectomy may be required for diagnosis.
目的
采用严格定义描述原发性脾淋巴瘤的影像学、临床及病理特征。
方法
21例患者中，9例有平片，10例有超声检查结果，16例有CT检查结果。我们将脾脏分为正常、肿大但无局灶性缺损（1型）、布满粟粒样肿块（2型）、含有大小不一的多灶性肿块（1 - 10厘米）（3型）或含有一个大于5厘米的孤立大肿块且无（4A型）或有（4B型）中心低密度/无回声区。
结果
临床表现为左上腹疼痛、体重减轻和/或发热。1例在CT检查时偶然发现。14例为4A型，3例为4B型，4例为3型，无1型或2型。10例中有9例为低回声。12例增强扫描病例中，11例病变相对于脾实质呈低密度，1例病变坏死。1例见边缘强化。
结论
原发性脾淋巴瘤通常表现为一个或多个肿块，而非仅脾肿大。可能需要行脾切除术以明确诊断。
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