肺黏膜相关淋巴组织淋巴瘤的CT及PET-CT表现

发布时间：2018-04-20 17:36

本文选题：淋巴瘤 + 肺肿瘤　；参考：《临床放射学杂志》2015年04期

【摘要】：目的总结肺黏膜相关淋巴组织淋巴瘤的CT及PET-CT表现,提高对该病的认识。方法回顾性分析21例经病理证实的肺黏膜相关淋巴组织淋巴瘤的CT及PET-CT的影像表现。结果所有患者均行CT扫描,其中20例行增强扫描,1例平扫。病灶密度均匀,除1例可见钙化外,其余病变均未见钙化,未见明显低密度区,平扫平均CT值为(47±11)HU,增强后平均CT值为(77±13)HU。发病部位以跨叶分布为主,19例有右中叶或左舌叶病变;CT征象:多发实变15例,多发结节3例,单发肿块2例,单发结节1例(合并结节病,多发小粟粒病灶)。其中病灶内支气管气相征16例,增强后病灶中出现血管造影征16例,病灶紧贴纵隔呈三角型灌注征13例。合并支气管扩张6例,有3例结节合并晕征,小叶间隔增厚9例,肺门及纵隔淋巴结增大9例,CT均显示为直径1.5 cm小淋巴结;胸腔积液7例,2例胸膜增厚,1例侵犯胸壁。6例行PET-CT检查,均显示病灶明显放射性浓聚,SUV值均2.5,为3.5~11.7,平均6.7±3.6;4例显示肺门及纵隔淋巴结有放射性浓聚,SUV值为2.7~3.4,平均3.0±0.3。结论肺黏膜相关淋巴组织淋巴瘤部分病灶在CT上有较具特征性的表现,对于诊断有一定提示作用;PETCT对于病灶活性的判断有一定优越性,最终确诊需要病理组织学和免疫组织化学。
[Abstract]:Objective to summarize CT and PET-CT findings of pulmonary mucosa-associated lymphoid tissue lymphoma. Methods CT and PET-CT findings of 21 cases of pathologically proved lung mucosa-associated lymphoid tissue lymphoma were retrospectively analyzed. Results CT scan was performed in all patients, of which 20 cases underwent enhanced scan and 1 case underwent plain scan. There was no calcification in all the lesions except one case with calcification. The mean CT value was 47 卤11 HUU on plain scan and 77 卤13 Hu on enhancement. There were 19 cases with right middle lobe or left tongue lobe lesions, including 15 cases of multiple consolidation, 3 cases of multiple nodules, 2 cases of single masses and 1 case of single nodules (complicated with sarcoidosis, multiple miliary lesions). Among them, 16 cases had bronchial vapor sign, 16 cases had angiographic sign after enhancement, 13 cases had triangle perfusion sign close to mediastinum. There were 6 cases of bronchiectasis, 3 cases of nodules with halo sign, 9 cases of interlobular septal thickening and 9 cases of hilar and mediastinal lymph node enlargement. In 7 cases of pleural effusion and 2 cases of pleural thickening and 1 case of pleural wall invasion, PET-CT examination was performed in 1 case. All of them showed that the value of SUV was 2.5 (3.5 卤3.6), and the mean value was 6.7 卤3.6 (4 cases). The mean value of SUV was 2.7 卤3.4 (mean 3.0 卤0.3) in hilar and mediastinal lymph nodes. Conclusion some lesions of lung mucosa-associated lymphoid tissue lymphoma have characteristic features on CT, which may be helpful for diagnosis. PETCT has some advantages in judging the activity of the lesions. The final diagnosis requires histopathology and immunohistochemistry.
【作者单位】：广州医科大学附属第一医院放射科;
【分类号】：R734.2;R730.44

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