胃肠道淋巴瘤的CT影像表现

目的探讨原发性胃肠道淋巴瘤的CT表现及其诊断价值。方法分析17例经临床病理证实的原发性胃肠道淋巴瘤的CT表现。结果原发性胃淋巴瘤11例(浸润型6例、溃疡型2例、肿块2例及混合型1例),其CT表现及特征有:弥漫或局限性胃壁增厚,厚度不均,壁不光整,其增厚内缘呈分叶状或波浪状,3例浸润型中增厚胃壁内缘表面伴有深浅不一溃疡影,周围间隙存在,增强后呈轻中度强化。原发性小肠淋巴瘤5例(浸润型3例和肿块型2例)、原发性升结肠淋巴瘤1例。其CT征象为:肠壁呈局限性或广泛性不均匀增厚,可伴肠管管腔狭窄,壁柔软,无明显梗阻征象,增强后呈轻中度强化。其中2例见腹膜后及肠系膜血管周围增大淋巴结形成肿块,并包绕肠系膜血管及周围脂肪。结论原发性胃肠道淋巴瘤的表现多种多样,但有较为明显的CT表现及特征,正确掌握其表现特征将有助于胃肠道淋巴瘤的诊断。

The CT features of primary gastrointestinal lymphoma

Objective To discuss the CT features of primary gastrointestinal lymphoma （PGIL） in order to improve the diagnosis. Methods 17 cases with PGIL proved by pathology were enrolled in this study. Results There were 11 cases of primary PGL （6 cases of infiltration, 2 cases af ulcer type. 2 cases of tumor and 1 case of mixed type）. The gastrointesti hal lymphoma CT findings were as follows. The involoed gastric walls showed diffused or localized thickening, the inner margin showed waved or lobulated shape and the exterior margin was clearly with perigastric fat existing. Three cascs of invasive type of thickening of the inner edge surface of gastric ulcers were associated with different shades of shadow. These tumors showed homogeneous density and light or moderate enhancement. PSIL was found in 5 patients （infiltration type in 3 cases, tumor in 2 cases）, and primary ymphoma of the ascending colonin 1 case. The CT findings were found that uneven wall thickening was localized or widespread, which may be associated with intestinal stenosis, wall soft, no obvious signs of obstruction. The intestinal cavity showed slight stdnosis without obvious obstruction. 2 cases showed en- largement of retroperitoneal and mesenteric lymph nodes and the formation of blood vessels around the tumor, surrounding mesenteric vessels and fat. Conclusion The performance of PGIL is varied, but PGIL has significant CT findings that have values in the diagnosis of gastrointestinal lymphoma.