孤立型脾脏单发淋巴管瘤CT影像特点与病理对照

发布时间：2018-07-28 21:24

【摘要】：目的探讨孤立型脾脏单发淋巴管瘤的CT影像特点与病理类型间的关系,加强对本病的认识,提高诊断水平。方法搜集本院经手术病理证实的孤立型脾脏单发淋巴管瘤10例,回顾性分析患者的临床、CT影像及病理资料,CT平扫10例,增强扫描9例。结果本组10例中,男4例,女6例,年龄32~79岁,平均53.4岁,其中8例无任何临床症状,由B超体检发现,仅2例有与脾脏增大相关的轻微临床症状。10例均为单发,共10个病灶,直径3.2~6.6 cm,CT平扫所有病灶均为囊性低密度灶,境界清楚8例,不清楚2例,其中形态不规则呈分叶状、密度不均、内见粗细不均分隔的病灶有6例,增强后病灶囊壁较薄,囊壁及分隔轻~中度强化,囊内容物除分隔外均无强化,病理均诊断为海绵状淋巴管瘤,另外4例形态规则呈类圆形、密度均匀、内无分隔的病灶,增强后病灶囊壁较薄,囊壁轻~中度强化,囊内容物密度均匀、均无强化,病理均诊断为囊状淋巴管瘤。10例中误诊为脾脏囊肿1例。结论孤立型脾脏单发淋巴管瘤少见,成年人发病率明显高于儿童,患者临床上无明显症状或症状轻微,病程较长,进展缓慢,其CT影像特点与病理类型有关,海绵状淋巴管瘤CT平扫病灶形态多不规则,呈分叶状,密度不均,内见粗细不均的分隔,增强后囊壁及分隔轻~中度强化,囊内容物除分隔外无强化;囊状淋巴管瘤CT平扫病灶形态较规则,呈类圆形,密度均匀,内无分隔,增强后病灶囊壁较薄,囊壁轻~中度强化,囊内容物无强化、密度均匀。
[Abstract]:Objective to investigate the relationship between CT imaging features and pathological types of solitary lymphangioma of the spleen, to enhance the understanding of the disease and improve the diagnostic level. Methods Ten cases of solitary lymphangioma of spleen proved by operation and pathology were collected. The clinical CT images and pathological data of 10 cases were retrospectively analyzed. Results there were 4 males and 6 females, aged 32 to 79 years (mean 53.4 years). Among them, 8 cases had no clinical symptoms. Only 2 cases had mild clinical symptoms associated with splenomegaly and 10 cases had 10 lesions. All the lesions were cystic low-density lesions with a diameter of 3.2 ~ 6.6 cm ~ (-1). The boundary was clear in 8 cases and unclear in 2 cases. The shape of the lesions was irregular in lobular shape and uneven in density. There were 6 lesions in which the thickness was uneven and the thickness was uneven, and the cystic wall of the lesions was thin after enhancement. The cyst wall and septum were slightly to moderately enhanced, the contents of the capsule were not enhanced except for the septum, and the pathological diagnosis was all spongiform lymphangioma. The other 4 cases were round in shape, homogeneous in density, and had no separated lesions. The cystic wall of the lesions was thin after enhancement. The cyst wall was enhanced slightly to moderately, the density of the contents of the capsule was uniform, and no enhancement was found in all the cases. One case was misdiagnosed as splenic cyst in all the 10 cases of cystic lymphangioma diagnosed by pathology. Conclusion solitary lymphangioma of spleen is rare, and the incidence of solitary lymphangioma in adults is significantly higher than that in children. There are no obvious symptoms or mild symptoms in the patients. The course of disease is longer and the progression is slow. The CT features of solitary lymphangioma are related to the pathological types. The CT plain scan lesions of spongiform lymphangioma were irregular in shape, lobulated, uneven in density, uneven in thickness, enhanced in the posterior cystic wall and mildly to moderately enhanced, and the contents of the capsule were not enhanced except for the septum. The CT plain scan lesions of cystic lymphangioma were regular in shape, round in shape, uniform in density and without internal separation. After enhancement, the cystic wall was thinner, the cyst wall was mildly to moderately enhanced, and the contents of the cyst were not enhanced and the density was uniform.
【作者单位】：湖北医药学院附属太和医院放射影像中心;
【分类号】：R733.2;R730.44

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