| 原发性肠道淋巴瘤的螺旋CT表型和征象分析 |
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| 引用本文： | 于铭,胡佳圆,宋焱,李飒英.原发性肠道淋巴瘤的螺旋CT表型和征象分析[J].CT理论与应用研究,2022,31(4):449-458. |
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| 作者姓名： | 于铭 胡佳圆 宋焱 李飒英 |
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| 作者单位： | 1.北京医院放射科，国家医学老年中心/中国医学科学院老年医学研究院, 北京100730 |
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| 摘 要： | 目的:探讨原发性肠道淋巴瘤（PIL）的CT表现，以提高该病的影像诊断和鉴别水平。方法:收集北京医院从2013年3月至2022年2月的21例经病理证实的PIL患者资料，分析其CT表型及特征表现。结果:21例PIL均为非霍奇金淋巴瘤（NHL）；12例为弥漫大B细胞淋巴瘤（DLBCL），3例为滤泡性淋巴瘤，2例为NK/T细胞淋巴瘤，2例为T细胞性淋巴瘤，黏膜相关淋巴组织淋巴瘤（MALT）和套细胞淋巴瘤（MCL）各1例；病变位于结肠7例，回肠5例，小肠系膜4例，回盲部2例，空肠1例，直肠1例，1例累及右半结肠和回盲部。CT检查显示，肠壁环周浸润型3例，肠壁增厚型3例，肿块型4例，动脉瘤样扩张型7例，肠系膜多发结节型4例。CT增强多表现为均匀的轻中度强化；21例患者中，2例合并肠穿孔，2例合并肠梗阻。结论:PIL的特征CT表现包括肠管多节段受累、肠壁局限性或弥漫性明显增厚、肠腔动脉瘤样扩张、偏心性密度均匀的肠腔肿块以及肠系膜“夹心面包征”，认识这些征象有助于提高对原发性肠道淋巴瘤的诊断。
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| 关 键 词： | 螺旋CT 淋巴瘤 肠肿瘤 病理学 |
| 收稿时间： | 2022-05-19 |
Analysis of Spiral CT Phenotypes and Features of Primary Intestinal Lymphoma |
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| Institution: | 1.Department of Radiology, Beijing Hospital; National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100730, China2.Graduate School of Peking Union Medical College, Beijing 100730, China |
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| Abstract: | Objective: To investigate the CT manifestations of primary intestinal lymphoma (PIL) so as to improve the diagnosis and differential diagnosis. Methods: 21 patients with PIL confirmed pathologically in our hospital from March 2013 to February 2022 were enrolled in this study, their CT phenotypes and features were analyzed. Results: All 21 cases of PIL were non-Hodgkin's lymphoma (NHL), 12 cases were diffuse large B-cell lymphoma (DLBCL), 3 cases were follicular lymphoma, 2 cases were NK/T-cell lymphoma, 2 cases were T-cell lymphoma, mucosa-associated lymphoid tissue lymphoma (MALT) and mantle cell lymphoma (MCL) were identified 1 case each. The lesions were located in the colon in 7 cases, ileum in 5 cases, small intestine mesentery in 4 cases, ileocecum in 2 cases, jejunum in 1 case, rectum in 1 case, and both right hemicolon and ileocecum in 1 case. CT findings showed intestinal wall infiltration in 3 cases, intestinal wall thickening in 3cases, mass in 4 cases, aneurysmal dilation in 7 cases and mesenteric multiple nodules in 4 cases. CT enhancement mostly showed homogeneous mild/moderate enhancement. Among the 21 patients, 2 case was complicated by by intestinal perforation, and 2 cases were complicated by intestinal obstruction. Conclusion: The characteristic imaging features of CT in PIL include multifocal involvement of the intestines, marked mural thickening in a focal or diffuse manner, aneurysmal dilatation of lumen, eccentric intestinal mass of uniform density and mesenteric "sandwich sign". Recognition of these signs is of diagnostic value for primary intestinal lymphoma. |
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