摘要
目的：探讨咽淋巴环淋巴瘤的CT及MRI表现，以提高诊断及鉴别诊断的准确性。方法：回顾性分析15例经病理证实、临床影像资料完整、原发于咽淋巴环淋巴瘤的CT及MRI表现。结果：病理均为非霍奇金淋巴瘤，B细胞来源10例，NK细胞或T细胞来源占5例。7例腭扁桃体淋巴瘤表现为扁桃体窝内边界清楚的类圆形软组织肿块，向咽腔内突出生长，5例为双侧受累；8例鼻咽及鼻腔淋巴瘤均表现为鼻咽腔内弥漫生长的软组织肿块，病变范围较大，向周围呈弥漫性生长，可累及邻近鼻甲及鼻窦骨质骨无颅底受侵；CT表现为均匀软组织密度肿块与周围界限清楚，MRI上T1WI呈与邻近肌肉组织相似的等密度，T2WI及DWI呈稍高密度，信号均匀，呈轻中度强化，无坏死和囊变；15例淋巴瘤中有10例同时可见双侧颈部淋巴结肿大。结论：咽淋巴环淋巴瘤以非霍奇金淋巴瘤多见，CT、MRI表现其密度、信号、边缘及强化特点有一定特征，需与结核、鼻咽癌及扁桃体癌等鉴别；CT、MRI能清楚显示肿瘤位置、形态、范围及有无颈部淋巴结肿大和周围组织的侵犯，对临床诊断和治疗有重要指导价值。
Abstract
Objective: To study CT and MRI features of lymphoma in Waldeyer’s ring, in order to improve the accurate diagnosis and differential diagnosis. Methods: The CT and MRI data of 15 cases of non-Hodgkin’s lymphoma in Waldeyer’s ring, proven pathologically and clinically were studied retrospectively. Results: Pathology showed all cases were non-Hodgkin’s lymphoma, including 10 cases from B cells, and 5 cases from NK cells or T cells. Seven cases of palatal tonsil lymphoma showed round soft tissue mass with clear border in amygdaloid pit, and five cases involved both sides. Eight cases of palatal tonsil lymphoma grew aggressively within nasopharyngeal cavity, and some cases had turbinate or nasal sinus bone metastasis. CT imaging showed clear border between the mass and para-tumor tissues. The lymphomas were isointense to neighboring muscle on T1WI, and hyperintense on T2WI and DWI, and the signals were homogeneous with mild-to-moderate enhancement, without necrosis and cystic appearances. Ten of the fifteen cases showed bilateral swelling of cervical lymph nodes. Conclusion: Pharynx lymphatic loop lymphomas were mostly non-Hodgkin’s lymphomas, and they had characteristics of density, signal intensity, borders, and enhancement on CT or MRI, which need differentiation from tuberculosis, nasopharyngeal carcinoma, and tonsil cancer. Both CT and MRI could describe the position, shape, extent, and whether or not having neighboring involvement, and these information are helpful for the clinical diagnosis and treatment.
关键词
淋巴瘤 /
咽肿瘤 /
体层摄影术 /
螺旋计算机 /
磁共振成像
Key words
Lymphoma /
Pharyngeal neoplasms /
Tomography /
spiral computed /
Magnetic resonance imaging
陈 刚;尹家保;徐 峰;张鹏程;党燕威.
咽淋巴环淋巴瘤的影像学诊断及鉴别[J]. 中国临床医学影像杂志. 2011, 22(10): 693-696
CHEN Gang;YIN Jia-bao;XU Feng;ZHANG Peng-cheng;DANG Yan-wei.
Imaging and differential diagnosis of lymphoma in Waldeyer’s ring[J]. Journal of China Clinic Medical Imaging. 2011, 22(10): 693-696
中图分类号：
Ｒ733.4
Ｒ739.63
Ｒ814.42
Ｒ445.2
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