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论著-头颈部

腹、盆部Castleman病的CT表现与病理对照

作者:王昌盛1 宋立强2

所属单位:1.重庆市酉阳县人民医院放射科(重庆 409800) 2.重庆医科大学附属第一医院院放射科(重庆 400016)

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摘要

目的探讨腹、盆部Castleman病(Castleman  disease,CD)的CT特征,并与病理学对照。方法  回顾性分析11例经手术病理证实CD的CT及病理资料。结果 ①7例位于腹膜后,3例位于肠系膜根部,1例位于髂血管走行区。局限型10例,为透明血管型,弥漫型1例为浆细胞型。②CT平扫10例呈等密度,1例为稍低密度,密度均匀,均无囊变坏死,2例中心见分支状钙化。CT增强:7例动脉期不均匀显著强化,3例中度均匀强化,1例轻度均匀强化,5例见明显强化血管;静脉期8例持续均匀强化,3例中心填充强化;延迟期均呈较均匀稍高密度。结论  腹、盆部CD的CT表现与病理类型密切相关,尤其是透明血管型CD表现具有一定特征,CT检查对CD诊断具有重要价值。

Objective To investigate the CT features and compared with pathology of Castleman disease (CD). Methods CT findings and pathology data of 11 cases with CD proved by pathology were analyzed retrospectively. Results ① There were 7 cases in the retroperitoneal, 3 cases in the mesenteric root, 1 case located in the iliac blood vessels pedestrian area. 10 cases were localized and pathological types were hyaline vascular type, 1 case was diffuse and plasma cell type. ② CT scan showed that 10 cases were equal density, 1 case was slightly low density, all were uniform density and without cystic necrosis, 2 cases l were seen branch calcification at centra. Contrast-enhanced CT: 7 cases showed heterogeneous significantly enhanced 3 cases homogeneous moderate enhancement and 1 case mild homogeneous enhancement at arterial phase, five cases were seen significantly enhanced tumor blood vessels around the edge or shadow; 8 cases continued homogeneous enhancement at intravenous, 3 cases center fill strengthen; all showed slightly more uniform density at delay period. Conclusion CT performance of CD of the abdomen and pelvis was closely related to the histological type, especially hyaline vascular type CD performance had a certain characteristic, CT examination had great value for the diagnosis of CD.

【关键词】Castleman病;腹部;体层摄影术;X线计算机

【中图分类号】R814.42;R445.2

【文献标识码】A

【DOI】 10.3969/j.issn.1672-5131.2015.01.24

前言

Castleman病(Castleman disease,CD)又名巨淋巴结增生症,是一 种少见原因不明的淋巴结增生性疾病,由Castleman等首先报道而得 名,多发生于纵隔及颈部,腹、盆部的CD更少见,极易误诊为其他富 血供肿瘤[1]。本文回顾性分析11例经手术病理证实的腹、盆部CD的CT 特点,探讨腹、盆部CD的CT特征及病理学基础,提高诊断水平。