原发性乳腺淋巴瘤的彩色多普勒声像图分析及其价值

目的：回顾性分析11例原发性乳腺淋巴瘤的声像图表现,以提高超声对原发性乳腺淋巴瘤的认识及诊断水平。方法复习2005年-2013年来我院经活检或手术病理证实的11例乳腺原发性淋巴瘤的彩色多普勒超声表现,分析其声像图特征。结果11例患者中,10例可见具体肿块,1例表现为乳腺结构紊乱,呈弥漫性低回声而无明确肿块。乳腺淋巴瘤单发5例,多发6例。10例为低回声,1例为高回声。其中5例为形态不规则的极低回声,其内部伴有条索状强回声,肿块边界不清,后方回声多增强,彩色多普勒显示血流信号较丰富。结论乳腺团块边界欠清晰,形态欠规则的低或极低回声,内伴有条索状高回声,后方回声增强,血流丰富且肿块多发时。应考虑到乳腺淋巴瘤可能。     

彩色多普勒超声对正常臂丛神经的辨认和鉴别

目的探讨彩色多普勒超声对正常臂丛神经的显像和定位价值。方法采用彩色多普勒超声观察了38例正常人臂丛神经干的走行、形态及声像图表现,并测量其内径。结果臂丛神经在横断面上表现为圆形或椭圆形的低回声结构,内部由点状回声组成。在超声监视下对9例健康人臂丛神经干进行了神经定位刺激,证实低回声结构为臂丛神经组织。结论彩色多普勒超声能够较好地显示和区别臂丛神经干。     

彩色多普勒超声对回盲区疾病诊断价值

目的探讨彩色多普勒超声对回盲区疾病的诊断价值。方法收集自2012年1月至2018年6月于北部战区总医院经手术和(或)病理证实的46例回盲区疾病患者的超声影像及临床资料。观察病变发生部位、范围、回声、累及肠道层次、肠腔狭窄情况、与周围组织关系及周边淋巴结的情况,并比较结肠镜及彩色多普勒超声两种方法对病变部位的检出情况。结果 46例患者中,阑尾病变15例,回肠末段及周围病变19例,升结肠近段病变12例。阑尾病变结肠镜及彩色多普勒超声的检出率分别为40.0%(6/15)、86.7%(13/15),差异有统计学意义(P<0.05)。回肠末段及周围病变结肠镜及彩色多普勒超声的检出率分别为47.4%(9/19)、84.2%(16/19),差异有统计学意义(P<0.05)。升结肠近段结肠镜及彩色多普勒超声的检出率分别为100.0%(12/12)、75.0%(9/12),差异无统计学意义(P>0.05)。良性病变超声图像表现为黏膜和肠壁水肿伴溃疡形成,肠壁均匀增厚。恶性病变可见新生物形成,肠壁呈不均匀增厚的低回声部分伴肠腔狭窄。病变肠管周围多数伴肿大淋巴结。肠套叠表现为长轴的"套筒征"、短轴的"同心圆征"。结论彩色多普勒超声对回盲部疾病的检查及诊断有其特征性表现,但需结合临床症状及其他影像检查结果作综合判断。     

结外淋巴瘤的超声表现

目的:探讨结外淋巴瘤的超声声像图表现特征。方法:回顾性分析经手术、胃镜或穿刺病理证实的49例结外淋巴瘤患者的超声声像图资料。结果:49例中,肠道淋巴瘤19例,超声表现为腹腔内较大异常低回声区或假肾征;胃淋巴瘤15例,超声表现为胃壁局限性或弥漫性增厚;睾丸淋巴瘤3例,超声表现分为局灶性和弥漫性2种,病灶呈低回声,部分病灶内可见网格样中等回声;皮下软组织淋巴瘤3例,超声表现为不均质低回声,部分病灶内可见网格样中等回声;甲状腺淋巴瘤2例,超声表现为甲状腺单侧叶弥漫性增大,内呈不均质低回声,伴网格样中等回声;腹膜后淋巴瘤2例,超声表现为腹部巨大实性不均质低回声包块或数个极低回声结节;卵巢、脾、乳腺、腮腺、附睾淋巴瘤各1例,超声均表现为病变部位不均质低回声病灶,或伴无回声区。CDFI以低分级血流为主。结论:结外淋巴瘤超声表现复杂多样,多数病灶呈不均质低回声及极低回声,部分病灶内伴网格样中等回声。结外淋巴瘤缺乏典型特征,很容易发生误诊。     

高频彩色多普勒超声对体表肿块的诊断价值

目的探讨高频彩色多普勒超声在体表肿块中的诊断价值。方法对67例体表肿块患者的超声表现进行回顾性分析,总结其声像图特征,根据其声像图形态、大小、内部回声、边缘回声、血流特点及是否有完整包膜,观察高频彩色多普勒超声对这些患者体表肿块的定性诊断。结果67例中脂肪瘤20例,胴窝囊肿15例,纤维瘤7例,腱鞘囊肿7例,坐骨结节囊肿6例,血管瘤5例,神经鞘膜瘤3例,皮脂腺囊肿3例,脂肪坏死1例。每种疾病声像图特征各异。结论在常见体表肿块的诊断及鉴别诊断中,高频彩色多普勒超声具有重要的临床应用价值。     

艾滋病患者颈部包块的超声表现

目的: 探讨艾滋病患者颈部包块的超声声像图特征.材料和方法: 对21例艾滋病患者颈部包块行超声检查并结合临床资料分析其图像特征.结果: (1)超声表现: 21例病例中有20例的超声表现为淋巴结肿大.其中,16例≥3cm的淋巴结/融合团块内可见大片无回声区,其内见细小点状回声漂浮,探头加压后见细小点状回声移动,彩色多普勒超声表现为尚存的实性回声部分可探及较多的红蓝彩色血流信号.(2)临床诊断: 16例为淋巴结结核,2例为真菌感染,2例为化脓性细菌感染,1例病理符合坏死组织之改变,培养未见真菌、细菌,病因学未明.结论: 艾滋病患者颈部包块淋巴结炎可能性大,其声像图表现具有一定特征.     

彩色多普勒超声诊断恶性淋巴瘤结外浸润的价值

目的：探讨彩色多普勒超声对恶性淋巴瘤结外浸润的诊断价值。方法：回顾性分析1995年以来经超声引导穿刺活检病理证实的结内恶性淋巴瘤结外浸润58例的二维及彩色多普勒超声表现及特征，33例同期进行了CT检查。结果：结内恶性淋巴瘤结外最易受侵的脏器为脾脏，其次是肝脏、肾脏及睾丸等。本组脾脏浸润42例，占72.41％；肝脏受侵14例，占24.14％；肾脏受侵5例，占8.62％。声像图主要特征为受累脏器弥漫或局限分布的低回声结节和血流信号的增多。依据声像图特点，可分为两型四种声像图表现。本组Ⅰ型12例；Ⅱ型46例。结论：彩色多普勒超声对结内恶性淋巴结外浸润的检查无创无痛、方便快捷、结果可靠，可作为本病首选的影像检查方法。     

彩色多普勒超声诊断门静脉海绵样变性

目的探讨门静脉海绵样变性（CTPV）的彩色多普勒超声的声像图特征及诊断价值。方法将彩色多普勒超声诊断为CTPV的19例患者与血管造影、CT和MRI及部分手术结果进行对照。结果彩超诊断符合率100％。彩超显示门静脉主干及分支周围呈蜂窝状、多条迂曲扩张的管状无回声,内充满红蓝相间彩色血流信号,脉冲多普勒示无回声内血流信号为门静脉样低速血流频谱。结论CTPV的彩色多普勒超声声像图具有特征性表现,彩超诊断CTPV准确率高,简便,无痛苦,具有重要的临床应用价值。     

肠道充盈法在回盲部结肠癌超声诊断中的辅助作用

目的讨论肠道充盈法在回盲部结肠癌超声诊断中的辅助作用。方法回顾性分析19例经手术证实的回盲部结肠癌患者肠道充盈法前后的声像图表现，病灶的大小、形态、内部回声及彩色多普勒血流信号。结果肠道充盈后19例回盲部结肠癌表现为肠壁限局性结节状向腔内突出或弥漫性非均匀性增厚，回声减低、层次分辨不清，黏膜面不光整，部分可见大小不一的溃疡凹陷。其中，肿块型6例，管壁增厚型4例，溃疡型9例。各型病灶均较充盈法前显示更为清晰，肠道充盈前后坷盲部结肠癌超声定性诊断率分别为52.6％和78.9％。结论肠道充盈对回盲部结肠癌的超声诊断有重要的辅助作用，可进一步提高其诊断准确性。     

肾上腺淋巴瘤的超声诊断

目的探讨肾上腺淋巴瘤的超声声像图特点,评价超声对该病的诊断价值。资料与方法回顾性分析12例经病理证实的肾上腺淋巴瘤患者的超声表现,评估病变的大小、形态、边界、内部回声及血流情况。结果 12例患者中,9例为双侧受累,3例为单侧,共21个病灶。病灶大小3.1～12.7cm,平均(7.8±3.7)cm。肿块形态呈不规则形12个,呈椭圆形或类圆形7个,呈肾上腺弥漫性增厚表现2个,类似于肾上腺增生。肿块内部主要表现为低回声,内部回声均匀12个,回声不均匀9个,其中4个内部可见条状高回声,3个内部可见片状无回声区。肿块边界清晰16个,边界不清5个。彩色多普勒血流显像示大部分病灶血流信号稀少或无明显血流信号。结论肾上腺淋巴瘤超声声像图表现具有一定的特征性,超声检查有助于与肾上腺其他肿瘤鉴别。     

肠道非霍奇金淋巴瘤临床病理学观察

目的:进一步认识肠道原发性NHL的临床病理学特征。方法:收集肠道淋巴瘤20例,应用多组织石蜡切片技术,免疫组化S-P方法标记观察。结果:20例中男16例,女4例,年龄12~78岁,平均53岁。临床表现以腹胀、下腹疼痛,腹内可触及包块为主要症状。发生部位回盲部8例、小肠7例、结肠4例、直肠1例。形态表现MALT型淋巴瘤19例,其中弥漫性大B细胞淋巴瘤伴MALT型淋巴瘤表现6例;肠病型间变性T细胞淋巴瘤1例。结论:肠道淋巴瘤以MALT型最多见,临床上很难与肠癌鉴别,早期诊断依赖肠镜活检,预后与规范化治疗有关。     

胃肠道黏膜相关淋巴组织淋巴瘤六例报告及文献复习

目的 报告6例胃肠道黏膜相关淋巴组织（mucosa-associated lymphoid tissue,MALT)淋巴瘤并结合文献探讨其影像学表现。方法 搜集经病理证实的胃肠道MALT淋巴瘤6例，其中来源于胃4例，十二指肠及回肠各1例，所有病例均经胃肠钡餐造影（GI）、CT或MRI检查。并复习了近几年国内外文献报道的胃肠道MALT淋巴瘤的临床及影像学表现。结果 根据该组病例临床及影像学所见，胃肠道MALT淋巴瘤临床及影像学特征为：（1）年龄在50岁以上，多为I－Ⅱ期低度恶性肿瘤，病程长，进展缓慢，症状轻，疗效好；（2）绝大多数幽门螺杆菌阳性，特别是胃MALT淋巴瘤；（3）GI示胃小区不规则增宽，多发性黏膜下小结节和多发边缘模糊的浅表溃疡，胃肠道黏膜皱襞粗大、紊乱迂曲，晚期呈多发息肉样结节、肿块及较大溃疡。CT及MRI表现为胃肠道壁环形光滑或小结节样增厚，肠MALT淋巴瘤可致肠腔狭窄。多发细小黏膜下病灶及多种征象共存是该病最重要的影像学特点。结论 典型影像学表现结合临床表现，可作出胃肠道MALT淋巴瘤的诊断。     

MSCT增强扫描在胃肠道MALT淋巴瘤诊断中的应用价值

目的 分析MSCT增强扫描在胃肠道黏膜相关淋巴组织(MALT)淋巴瘤诊断中的应用价值.方法 回顾性分析经病理证实的11例胃肠道MALT淋巴瘤的临床和影像资料,分析病变部位、形态表现、增强表现、淋巴结肿大及其他结外器官的受累情况等.结果 (1)形态表现:弥漫性增厚型8例(72.7%),其中胃5例,肠3例;局限性肿块/结节型3例(27.3%),其中胃2例,肠1例;肿瘤导致管腔"动脉瘤样扩张"2例,均发生于肠道;另有1例回盲部局限性肿块/结节型,病灶致局部肠腔狭窄.(2)增强表现:10例(90.9%)中度或明显强化,9例(81.8%)均匀强化.(3)淋巴结及其他结外器官受累情况: 5例(45.5%)累及区域淋巴结,1例(9.1%)累及区域淋巴结及膈下远处淋巴结,1例(9.1%)同时累及膈肌两侧淋巴结;2例(18.2%)伴有其他结外器官受累.(4)临床分期:Ⅰ~Ⅱ期9例(81.8%),Ⅳ期2例(18.2%).结论 MSCT增强扫描可为胃肠道MALT淋巴瘤的诊断和分期提供可靠依据,建议将胸部和腹盆腔联合增强扫描作为常规检查项目.     

肠道恶性淋巴瘤的影像诊断

目的　探讨肠道恶性淋巴瘤的影像特点。方法　复习经手术及病理证实的肠道恶性淋巴瘤 3 2例 ,其中X线钡餐 2 0例 ,双对比灌肠 12例 ,CT扫描 10例 ,B超 19例。结果　钡剂造影发现小肠或回盲受累 2 0例 ,包括小肠局部扩大 6例 ,腔内多发息肉状增生 7例 ,肠壁浸润 4例 ,腔内增生伴溃疡 3例。病灶局限于大肠者 12例 ,分别是腔内肿块 6例 ,肠腔狭窄 5例和粘膜粗大 1例。 10例CT中见肠壁不规则增厚 5例 ,腔内偏侧肿块 2例 ,肠扩大伴壁厚 3例。B超发现异常 13例 ,其中肠壁增厚的条状低回声 5例 ,假肾征 6例 ,团状低回声 2例。结论　肠道淋巴瘤的X线、CT、超声表现各有特点 ,X线钡剂造影与CT或超声结合可提高诊断准确率     

Mucosa-associated lymphoid tissue of nasopharynx: A case report and literature review

Nasopharyngeal MALT lymphoma is a rare disease, with limited cases reported in the literature. To the best of our knowledge, there is no research detailing the treatment of nasopharyngeal MALT lymphoma. In this present paper, we report an unusual case of a 70-year-old female patient with nasopharyngeal MALT lymphoma. The patient was treated with radiotherapy alone. The detailed radiation therapy of the treatment was demonstrated. The patient is free of locally recurrent or distant disease at two years. Radiotherapy alone can be a helpful treatment for MALT lymphoma confined to the nasopharyngeal cavity.     

Lymphoma of the small intestine: radiological appearances

The radiological features of small intestinal lymphoma are described in 11 patients examined using the small bowel enema technique. The signs include luminal narrowing with mucosal destruction and occasionally shouldering of the margins and stricture formation, broad based ulceration, cavitation, non-specific thickening of the valvulae conniventes, discrete intraluminal filling defects, and a mass. In one patient, small nodules were scattered throughout the small intestine. Aneurysmal dilatation of a segment of intestine was seen in one case and an extraluminal mesenteric mass in another. A combination of different signs was a frequent finding and multiple intestinal lesions were present in four cases. Predisposing factors were present in five cases including coeliac disease, chronic lymphatic leukaemia, immunoproliferative small intestinal (alpha-chain) disease and previous extraintestinal lymphoma. In another patient there was evidence of extraintestinal lymphoma at the time of presentation.     

原发性小肠淋巴瘤（I）：组织学类型及CT诊断

原发性小肠淋巴瘤（PSIL）是指原发于十二指肠、空肠和回肠黏膜下淋巴组织的恶性肿瘤,较少见,绝大多数为非霍奇金淋巴瘤。CT肠道成像对显示小肠淋巴瘤具有重要价值。充分认识该病的临床和影像学表现是正确诊断与鉴别诊断的基础。就PSIL的临床表现、CT肠道成像检查及其影像表现进行介绍,旨在提高对该病的诊断水平。     

CT appearances of mucosa-associated lymphoid tissue (MALT) lymphoma

Mucosa-associated lymphoid tissue (MALT) lymphoma is a low-grade lymphoma that differs from high-grade non-Hodgkin lymphoma both clinically and histologically. The CT appearances of MALT lymphoma are described. Of 40 patients referred with biopsy-proven MALT lymphoma, only seven had not had gastrectomy or chemotherapy prior to CT examination. The CT scans of these seven cases were analysed for the degree and extent of gastric wall thickening, enlargement of abdominal and extra-abdominal lymph nodes, and presence of extranodal disease. In all patients the stomach was distended with oral contrast medium and scans performed at narrow collimation, after intravenous administration of 20 mg hyoscine butylbromide. In six patients focal thickening of the gastric wall was 1 cm or less. One patient had thickening of over 4 cm. There was no enlargement of abdominal or extra-abdominal lymph nodes or extension to adjacent organs. Thus on CT, at presentation, MALT lymphoma results in minimal gastric wall thickening, unlike high-grade non-Hodgkin lymphoma, which typically causes bulky gastric disease, nodal enlargement and extension into adjacent organs. CT is therefore of limited value in monitoring response to treatment. With disease greater than minimal thickening, transformation to a higher grade should be considered. Received: 22 April 1998; Accepted: 27 October 1998     

Gallium-67 citrate scintigraphy and marginal zone lymphoma of the mucosa-associated lymphoid tissue. Ocular MALT

We describe marginal zone lymphoma of the mucosa-associated lymphoid tissue (MALT) and especially MALT lymphoma occurring in the conjunctiva. Tumors of the conjunctiva and cornea are grouped into two major categories of congenital and acquired lesions. Lymphoid tumors of the conjunctiva are acquired tumors and can occur as an isolated lesion or can be a manifestation of systemic lymphoma. Primary lymphomas of the conjunctiva are extremely rare usually originate from extranodal marginal zone B-cell non-Hodgkin's lymphomas of MALT and occur among older adults with a mean age of 61 years. In the last decade it has been reported that MALT lymphomas may develop in various extraintestinal locations, sometimes even without the presence of a mucosa. Half of MALT lymphomas occur in the gastrointestinal tract. MALT lymphomas of the eye are rare and originate from the conjunctiva and the lacrimal glands. Studies evaluating the clinical impact of 67Ga-C scintigraphy for MALT-type lymphomas imaging are rare, based on small numbers, heterogenous groups of patients. Clinical examination, excisional biopsy, histopathology and immunohistochemical studies, computerized tomography and magnetic resonance imaging are also used for the diagnosis of cunjunctival MALT disease. A case of ours gives reason for further discussion. Treatment and follow-up of MALT lymphoma is described.