原发性胃肠道淋巴瘤的多层螺旋CT表现

目的探讨原发性胃肠道淋巴瘤（PGIL）的多层螺旋CT（MDCT）表现,以提高该病的诊断和鉴别诊断水平。方法收集36例复旦大学附属肿瘤医院2006年1月—2014年6月经病理证实的PGIL患者资料,总结其CT特征表现及诊断和鉴别诊断要点。结果 36例PGIL均为非霍奇金淋巴瘤（NHL）,28例为弥漫大B细胞淋巴瘤（DLBCL）,8例为黏膜相关淋巴组织（MALT）淋巴瘤。病变位于胃20例,空、回肠10例,十二指肠3例,回盲部2例,直肠1例。CT检查示32例胃肠道管壁呈弥漫增厚伴均匀强化,周围常有肿大淋巴结影;4例胃壁局限性增厚呈结节、肿块影。动脉瘤样扩张是肠道淋巴瘤的特征性表现。病灶周围增粗血管或增粗血管穿行于病灶是胃肠道淋巴瘤的重要表现。结论 PGIL的CT表现有一定特征性,有望提高诊断正确率。

Multi-detector CT features of primary gastrointestinal lymphoma

Objective To describe the multi-detector computed tomography （MDCT） features of primary gastrointestinal lymphoma （PGIL）, and to improve the diagnosis and differential diagnosis ability.Methods A total of 36 cases of PGIL confirmed by pathological examination in Fudan University Shanghai Cancer Center from January 2006 to June 2014 were selected. Combining with literatures, the 36 patients’ CT images were analyzed retrospectively.Results All PGILs belonged to non-Hodgkin’s lymphoma （NHL）, 28 with diffuse large B-cell lymphoma （DLBCL） and 8 with mucosa-associated lymphoid tissue （MALT） lymphoma. 20 lesions were located in stomach, 10 lesions in jejunum and ileum, 3 lesions in duodenum, 2 lesions in ileocecal junction, and 1 lesion in rectum. Thickening of the wall of the gastrointestinal tract with homogeneous enhancement was the typical feature of PGIL which was shown in 32 cases. Meanwhile tumescent lymph nodes were also shown. Aneurysmal dilatation was the characteristic feature of intestinal lymphoma. Enlargement or thickening vessel around lesion was an important manifestation of gastrointestinal lymphoma. Conclusion PGIL has specific MDCT features, and MDCT is helpful in improving diagnosis rate.