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肌肉软组织淋巴瘤的影像诊断

作者:明小春 龙世亮 温凤玲 李土程 蔡德总

所属单位:广东省湛江市中心人民医院CT、MR室(广东 湛江 524037)

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摘要

目的分析肌肉软组织淋巴瘤的 影像表现,探讨CT和MRI对肌肉软组织淋 巴瘤的诊断价值。方法 回顾性分析经病 理证实的7例软组织淋巴瘤的CT或MRI影像 表现,其中MR检查4例,CT检查3例。结 果 影像诊断与病理结果对照,术前影像 诊断肌肉软组织淋巴瘤2例,误诊为肉瘤 2例,误诊为转移瘤2例,误诊为纤维瘤1 例。MRI表现为T1WI等信号2例、略低信号 2例,T2WI呈稍高信号,反转恢复序列均 呈稍高信号,肿瘤内信号均匀、坏死及囊 变少见;MR增强扫描均匀强化2例,不均 匀强化1例,1例未行MR增强检查。CT平扫 密度均匀,与正常肌肉相仿,增强扫描呈 均匀中度强化。结论 软组织淋巴瘤的CT 和MRI表现有一定特点,影像学检查有助 于肌肉软组织淋巴瘤的诊断。

Objective To analyze the imagine manifestation of muscular soft tissue lymphoma and explore CT and MRI features. Methods This was a retrospective review of CT or MRI studies of 7 patients with histologically confirmed diagnosis of muscular soft tissue lymphoma, including MRI in 4 cases, CT in 3 case. Results Imaging Diagnosis was compared with pathological results, diagnosis before the operation were muscle lymphoma(2 cases),sarcoma(2 cases), metastatic tumor(2 cases) and fibroid tumor(1 case). On MR T1WI,2 were intermediate signal intensity and 2 were slightly low signal intensity. On MR T2WI, all were slightly high signal intensity. On FLAIR, all were slightly high signal intensity. The lesions were homogeneous,and systis and necrosis in lesions were rare. In the 3 conrtast-enhanced cases,2 were homogeneous and 1 was inhomogeneous. The les-ions were homogeneous, which were isoettenating to normal muscle on unenhanced CT images, after intravenous injection of contrast media, the lesions enhanced homogeneously. Conclusion There are several characteristics on the imaging of CT and MR of muscular soft tissue lymphoma, and image examination are helpful for the diagnosis of muscular soft tissue lymphoma.

【关键词】软组织;淋巴瘤;体层摄影术;X线计算机;磁共振成像;诊断

【中图分类号】R733.4;R738.6

【文献标识码】A

【DOI】 10.3969/j.issn.1672- 5131.2018.09.042

前言

淋巴瘤是免疫系统的恶性肿瘤,多发生于淋巴结或富含淋巴的结 外器官,临床表现为无痛性进行性淋巴结肿大或局部肿块。发生于肌 肉软组织的淋巴瘤非常少见,除了肌肉受累,同时也可侵犯邻近皮 下、肌间隙脂肪等组织,分为原发性及继发性,可为全身淋巴瘤的一 部分,也可以单独发生[1]。按病理学改变可分为霍奇金淋巴瘤和非霍 奇金淋巴瘤。本文旨在通过分析5例经病理证实的软组织淋巴瘤的影像 表现,以提高对这一少见病的认识。