原发性脾脏B细胞淋巴瘤CT特征

目的探讨原发性脾脏B细胞淋巴瘤的CT表现特征。方法回顾性分析11例经病理证实的原发性脾脏B细胞淋巴瘤CT表现。结果左上腹不适8例、隐痛6例、胀痛5例、乏力10例、低热8例、食欲下降7例、体重减低8例,左上腹扣击痛8例、压痛6例。弥漫大B细胞淋巴瘤8例:其中孤立肿块型7例,肿块5.5～12.0cm,平扫呈低密度5例,等密度2例;界限清楚5例,不清楚2例;增强扫描于动脉期轻度强化5例,无强化2例;界限清楚5例,不清楚2例;静脉期轻度强化3例,无强化4例;实质期轻度强化2例,无强化5例。粟粒结节型1例,平扫呈等密度,增强扫描脾脏实质强化,内见直径2.1～2.8cm多发低密度结节。小B细胞淋巴瘤1例(粟粒结节型):平扫示脾脏肿大,内见1.5～2.0cm多发结节状低密度灶,界限不清楚;增强扫描脾脏实质强化,低密度小结节灶无强化,界限清楚。套细胞淋巴瘤1例(多发肿块型):平扫见脾脏增大,肿块呈等密度,增强扫描动脉期显示脾脏实质强化,内见3.5～7.8cm的低密度肿块影,界限清楚,静脉期和实质期肿块边缘模糊。毛细胞淋巴瘤1例(弥漫型):脾脏呈弥漫性增大,平扫和增强均未发现明确肿块及结节灶。结论原发性脾脏B细胞淋巴瘤以孤立巨块型弥漫性大B细胞淋巴瘤多见,CT平扫以低密度或等密度;增强扫描轻度强化或不强化为特征。

The CT features of primary splenic B-cell lymphoma

Objective To study of CT features of primary splenic B-cell lymphoma. Methods CT findings of 11 primary splenic B--cell lymphoma, which were proven by pathology, were retrospectively analysed. Results There were 8 pa- tients with discomfort in left upper abdomen, 6 with dull pain, 5 with distending pain, 10 with hypodynamia, 8 with low fever, 7 with loss of appetite, 8 with decreased body weight, 8 with button strike pain, and 6 with tenderness of left upper abdomen. There were 8 patients with diffuse large B-cell lymphoma. Of these 8 patients, 7 were isolated massive type, with an average of 5.5-12.0 cm in diameter; 5 presented with low density and 2 wit isodense density, 5 with clear limit and 2 with unclear bound; 5 showed slight enhancement, 2 no enhancement, 5 clear boundaries, and 2 unclear boundaries in arterial phase; 3 presented with slight enhancement and 4 without enhancement in venous phase; 2 had been showed slight enhancement and 5 no enhancement in parenchymal phase in enhanced scans. The remaining one was miliary nodule type, which presented with isodense density in plain scan, with multiple low density nodules of 2.1-2.8 cm in diameter in spleen parenchyma of enhanced scan. There was 1 patient with small B-cell lymphoma （miliary nodules）. The patient showed enlarged spleen, with multiple nodular low-density lesions of 1.5-2.0 cm in diameter in enlarged spleen, unclear of massive limit of plain scan, hut no enhancement and clear limit were found in enhanced scan. There was 1 patient with mantle cell lymphoma （multiple tumor types）. The patients showed enlarged spleen and isodense density, with low-densi- ty mass 3.5-7.8 cm in diameter in plain scan, clear limit in enhanced scan in arterial phase, and blur edge in venous phase. There was 1 patient with hair-cell lymphoma （diffuse types）. The patient showed diffuse increased spleen, but a clear mass and nodules were not found in plain scan and enhanced scan. Conclusion Most of the diffuse large B-cell lym- phoma were belonged to isolated massive type. The low density and isodense density in plain scan, slight enhancement and no enhacement in enhanced scan, were the CT characteristics of primary splenic B-cell lymphoma.