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鼻腔鼻咽部NK/T细胞淋巴瘤的CT表现

作者:索方方

所属单位:郑州大学附属洛阳中心医院放射科(河南 洛阳 471009)

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摘要

目的 探讨鼻腔鼻咽部NK/T细胞 淋巴瘤的CT表现特征。方法 回顾性分析 经手术病理证实的23例鼻腔鼻咽部NK/T细 胞淋巴瘤的临床资料及CT表现。结果 鼻 腔病变为主者18例,均位于单侧鼻腔,位 于鼻腔前部11例,后部4例,呈弥漫表现 的3例;CT表现肿块呈密度均匀的软组织 密度影,增强后轻至中度强化;其中11例 鼻中隔受累,5例伴有鼻咽受侵,13例合 并鼻旁窦窦腔透光度降低,9例鼻前庭皮 肤受侵犯,8例相邻骨质侵蚀破坏。鼻咽 部病变为主者5例,表现为鼻咽顶后壁及 侧壁不均匀增厚的软组织密度影,2例内 可见气泡影,表面不光滑,增强后轻至中 度强化;咽旁间隙受侵3例,鼻后孔受侵2 例。结论 鼻腔鼻咽部NK/T细胞淋巴瘤的 CT表现具有一定的特征性。

Objective To investigate the CT features of natural killer cell/T-cell lymphoma in nasal cavity and nasopharynx (NKTCL). Methods Retrospectively analyzed the clinical date and CT findings of 23 patients with natural killer cell/T-cell lymphoma in nasal cavity and nasopharynx by surgery and pathology. Results Nasal cavity was mainly involved in 21 patients, all cases were located in one nasal cavity, the localized lesions were found in the anterior nasal cavity in 11 patients and in posterior part in 4 cases and diffuse performance in 3 patients. CT showed mass density was uniform density of soft tissue density, enhanced light to moderate enhancement; Involvement of nasal septum was detected in 11 patients and nasopharynx in 6 patients. The nasal cavity included paranasal sinuses in 13 patients and subcutaneous soft tissue of the face in 9 patients, bony destruction was demonstrated in 12 patients. Nasopharyngeal lesions in 5 cases, the performance of the nasopharyngeal wall and posterior wall of the uneven thickening of the soft tissue density, 2 cases of bubbles within the visible, the surface is not smooth, enhanced mild to moderate enhancement. Clearance in 3 cases, 2 cases of posterior nasal perforation. Conclusion Some CT features may suggest the diagnosis of natural killer cell/ T-cell lymphoma in nasal cavity and nasopharynx.

【关键词】淋巴瘤;鼻腔;鼻咽;体层摄 影术,X线计算机

【中图分类号】R765.2;R733.4

【文献标识码】A

【DOI】10.3969/j.issn.1672- 5131.2017.05.016

前言

鼻型NK/T细胞淋巴瘤是一种罕见的非霍杰金淋巴瘤,占非霍杰金 淋巴瘤5%~18%[1]。以前曾称为恶性肉芽肿、坏疽性肉芽肿、致死性中 线肉芽肿、Stewart肉芽肿、特发性中线破坏性疾病和血管中心性T细 胞淋巴瘤等,主要发生于结外,最常累及鼻腔,单个或多个鼻窦,或 同时累及鼻腔及鼻窦,其次是咽部、上腭及气道等部位[2-3]。其早期临 床表现不典型,通常表现一个高侵袭性的临床过程,预后不佳。本文 回顾性分析23例鼻腔鼻咽部NK/T细胞淋巴瘤的CT表现,总结其诊断特 征,以提高对本病的诊断正确率。