肝脏淋巴瘤CT诊断及临床分析

发布时间：2018-03-29 17:03

本文选题：肝脏　切入点：淋巴瘤　出处：《中华肿瘤防治杂志》2017年16期

【摘要】：目的肝脏淋巴瘤临床罕见,既往容易误诊误治。本研究通过分析5例肝脏淋巴瘤的CT表现及临床特点,以期提高对其诊治水平。方法回顾性分析2009-02-11-2016-04-30经3家医院(淄博市第一医院1例,上海市金山区中西医结合医院1例,复旦大学附属中山医院3例)诊治的5例病理及临床治疗证实的肝脏淋巴瘤患者的CT及临床资料。结果 5例中原发2例,继发3例。3例表现为肝内边界较清楚的结节和(或)肿块,最大直径34~107mm,1例多发,2例单发;另外2例呈肝内边界模糊的多发斑片状"地图样"浸润。CT平扫病灶呈较均匀低或稍低密度,CT值为19.8~43.4Hu。增强5例肿瘤动脉期均轻度强化,门脉期呈轻到中度持续强化,但弱于正常肝组织,平均CT值45.6~63.9Hu,延迟期强化均减弱呈较低密度。4例肿瘤中见"血管漂浮征";3例见腹腔、腹膜后肿大淋巴结,较均匀中度强化;临床3例出现低热及浅表淋巴结肿大;2例出现腹痛、腹胀及消瘦;1例扪及腹部包块;1例无特殊症状。5例均无明显肝硬化,4例出现肝功能异常,2例合并乙型肝炎。2例原发性者经外科手术治疗及内科治疗,3例继发性者经中西医结合内科综合治疗。4例经随访分别生存16~39个月,平均生存21个月,1例术后随访至7个月,未见复发转移。结论肝脏淋巴瘤罕见而预后不佳,临床以低热、全身消耗症状、肝脏肿块及腹痛为主,CT可以显示病灶的一些病理学变化,对其诊断具有较大价值。
[Abstract]:Objective to analyze the CT features and clinical features of 5 cases of hepatic lymphoma. Methods three hospitals (1 case of Zibo No. 1 Hospital and 1 case of Shanghai Jinshan District Integrated Chinese and Western Medicine Hospital) were retrospectively analyzed in 2009-02-11-2016-04-30. Ct and clinical data of 5 cases of liver lymphoma confirmed by pathology and clinical treatment were studied in Zhongshan Hospital affiliated to Fudan University. In 3 cases, 3 cases showed clear intrahepatic boundary nodules and / or masses, and 2 cases had multiple lesions in 1 case with a maximum diameter of 34 10 7 mm. In the other 2 cases, multiple patchy "map like" infiltration with blurred intrahepatic boundaries. The CT value of CT plain scan was 19.8% 43.4 Hu.Enhancement was mild to moderate enhancement in arterial phase in 5 cases, mild to moderate enhancement in portal phase. But it was weaker than normal liver tissue, with an average CT value of 45.6 ~ 63.9 Hu.The delayed phase enhancement showed a low density of 4 cases. "Vascular floating sign" was seen in 3 cases, abdominal cavity was found in 3 cases, retroperitoneal lymph nodes were enlarged, and the enhancement was even and moderate. There were 3 cases of low fever and 2 cases of superficial lymphadenopathy with abdominal pain. Abdominal distension and emaciation: 1 case palpable abdominal mass. 1 case without special symptoms. 5 cases without obvious liver cirrhosis. 4 cases with abnormal liver function. 2 cases with hepatitis B. 2 cases with primary hepatitis B. 2 cases with primary hepatitis B. 3 cases with secondary disease after surgical and medical treatment. 4 cases were followed up for 16 ~ 39 months after comprehensive treatment of integrated traditional Chinese and western medicine. The average survival time was 21 months and 1 case was followed up to 7 months after operation without recurrence and metastasis. Conclusion liver lymphoma is rare and has poor prognosis. Ct can show some pathological changes of liver masses and abdominal pain, which is of great value in the diagnosis of liver masses and abdominal pain.
【作者单位】：淄博市第一医院肿瘤科;上海市金山区中西医结合医院放射科;复旦大学附属中山医院放射科;
【分类号】：R730.44;R735.7

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