腮腺腺淋巴瘤的MSCT、MRI表现及临床病理回顾性分析

目的探讨腮腺腺淋巴瘤的MSCT、MRI表现与临床病理的关系。方法对经病理证实的48例腮腺腺淋巴瘤MSCT、MRI表现及临床病理进行回顾性分析。结果 48例腮腺腺淋巴瘤患者,其中42例为单发病灶,6例为多发病灶,肿块位于腮腺浅叶后下方44/54(81.48%),其中同时累及腮腺深叶的6个;肿块边缘清楚52/54(96.30%),包膜在MRI上表现为T1WI及T2WI上环状低信号;肿块长轴与下颌骨升支平行者40/54(74.07%),48例均行MSCT及MRI平扫,15例行MSCT增强扫描,16例行MRI增强扫描,MSCT及MRI平扫呈实性或不均匀性密度(信号)肿块,增强扫描实性部分多呈明显强化,囊性部分不强化或呈斑点、裂隙状、花斑状或豹纹状相对低密度(信号)灶,肿块周围增大淋巴结18枚;临床特点是43/48(89.58%)的病人有吸烟史,48例中,男44例,女4例,50岁以上者37/48(77.08%);病理特点是肿块包膜完整,切面可见囊腔,镜下囊腔衬覆特征性嗜酸性双层上皮细胞,上皮多呈乳头状排列,间质为淋巴细胞,送检发现22枚周围淋巴结呈反应性增生。结论腮腺腺淋巴瘤患者的MSCT、MRI表现有一定特点,其与病理也有一定的对应性,体现在肿块包膜完整及内部囊变上,再密切结合中老年男性、吸烟史进行分析可提高诊断准确性。

Retrospective Analysis on the MSCT and MRI Manifestations and Clinical Pathology of Parotid Gland Adenolymphoma

Objective To discuss the relationship between the MSCT and MRI manifestations and the clinical pathology of parotid gland adenolymphoma.Methods Retrospective analysis has been carried out on the MSCT and MRI manifestations and clinical pathology of 48 patients who are pathologically diagnosed with parotid gland adenolymphoma.Results Among the 48 patients with parotid gland adenolymphoma, 42 of them were with single focus and the other 6 were with multiple focuses. The proportion of patients with lump behind and underneath the superficial lobe of parotid gland was 44/54 (81.48%). Among them, 6 patients also had lesion on the deep lobe; the portion of lump with clear edge was 52/54 (96.30%), with the MRI capsule manifestations of low signal on T1WI and T2WI rims; the proportion of patients with the long axis of lump parallel with underjaw ascending limb is 40/54 (74.07%). For all 48 cases, MSCT and MRI plain scan have been carried out. 15 of them had MSCT enhancement scan; 16 of them had MRI enhancement scan. The MSCT and MRI plain scan results showed lumps with solid or nonhomogeneous density (signal). The parenchyma parts in enhancement scans were mostly obviously intensified. The cystic portions were not intensified or showed lesions with spots, fissures, piebald, or leopard with relatively low density(signal). 18 cases showed enlarged lymph nodes around the lumps. In terms of clinical features, 43/48(89.58%) of the patients have history of smoking. Among the 48 patients, 44 were male and 4 were female. 37/48(77.08%) were aged over 50. In terms of pathological features, the lumps have complete capsules. Cyst cavity could be seen from the section. The cyst cavity under the scope were lined by characterized acidophilic bistratified epithelial cells. The epithelium was in the papillary form and the interstitial substance was lymphocytes. 22 of the submitted samples of peripheral lymph nodes showed reactive hyperplasia.Conclusion There are certain features in the MSCT and MRI manifestations of parotid gland adenolymphoma patients, which is in accordance with its pathological features. These are manifested in the completeness of lump capsules and internal cystic lesions. In addition, if we consider the factors related to middle-aged and senior males and analyze their history of smoking, the accuracy of diagnosis can be improved.