CT findings in peripheral T-cell lymphoma involving the gastrointestinal tract

PURPOSE: To evaluate whether computed tomography (CT) accurately depicted gastrointestinal tract involvement in peripheral T-cell lymphoma (PTCL). MATERIALS AND METHODS: CT scans were retrospectively reviewed in 14 patients with pathologically proved PTCLs of the gastrointestinal tract for the following considerations: sites, patterns of involvement (ie, morphologic features, bowel wall thickness or mass size, and contrast enhancement pattern), and ancillary findings at other sites (ie, lymphadenopathy, bowel perforation, and involvement of other organs). RESULTS: PTCL involved the stomach in three patients, the small intestine in eight, both the stomach and the small intestine in one, and the sigmoid colon in two; multifocal involvement was seen in three (21%) patients. CT failed to demonstrate the bowel lesions in three of 14 patients. At CT, 11 patients had gastric or bowel wall thickening (n = 10) and a polypoid mass (n = 1). In 10 patients, the gastric or bowel wall thickening was mild (<1 cm) in six, moderate (1-2 cm) in three, and severe (>2 cm) in one. Lymphadenopathy was noted in nine (64%) patients, with the nonbulky type in eight and the bulky type in one. Bowel perforation occurred in four (29%) patients. Other organs were involved in eight (57%) patients. CONCLUSION: CT can depict PTCL involving the gastrointestinal tract if it is not confined to the mucosa. There is a tendency toward preferential jejunal or duodenal involvement, as well as bowel perforation.     

鼻腔T/NK细胞型淋巴瘤的影像学诊断

目的探讨鼻腔T/NK细胞型淋巴瘤的CT和MRI特点。方法回顾性分析35例经组织学证实鼻腔T/NK细胞型淋巴瘤的影像学资料。结果根据病变的范围分为局限型和弥漫型2种类型。CT表现:局限型25例,位于鼻腔前部23例,后部2例,向前浸润鼻前庭、鼻翼、鼻背及邻近面颊部皮肤23例;病灶密度均匀8例,不均匀17例,增强后低度强化6例,中度强化3例;中下鼻甲、鼻中隔轻微浸润性破坏2例。弥漫型10例,表现为鼻腔中线区骨质破坏伴软组织肿块,9例侵犯邻近鼻窦及面颊部软组织,6例蔓延到眼眶、颞下窝、翼腭窝,4例浸润颅底骨髓,3例破坏硬腭。MRI表现:T1WI低信号5例(与肌肉比较,以下同),等信号3例;T2WI高信号6例,等信号2例;病变低度强化2例,中度强化4例。3例沿翼腭窝神经周围蔓延。结论大多数鼻腔T/NK细胞型淋巴瘤有特征影像学征象,可提示诊断。     

鼻腔鼻窦淋巴瘤的CT和MRI诊断

目的 探讨鼻腔鼻窦淋巴瘤的CT和MRI表现,旨在提高其诊断准确性。资料与方法 回顾性分析46例经手术或活检证实的鼻腔鼻窦淋巴瘤患者的影像资料。结果 原发于鼻腔30例,鼻窦7例,鼻腔、鼻窦同时发病或累及邻近结构9例。CT表现：淋巴瘤位于鼻腔前部28例,后部2例,向前浸润鼻前庭、鼻翼、鼻背及邻近面部皮肤22例;病灶密度均匀8例,不均匀22例,增强后轻度强化7例,中度强化6例,鼻中隔、中下鼻甲浸润性破坏7例。鼻窦淋巴瘤表现为窦腔内充以软组织影,窦壁骨质浸润性改变5例,明显破坏2例,4例上颌窦周软组织浸润,增强后中度强化3例。弥漫型淋巴瘤表现为鼻腔中线区不同程度的骨质破坏,鼻腔及邻近鼻窦伴软组织肿块,6例并累及邻近面部软组织、眼眶、鼻咽部、口咽、颞下窝、翼腭窝,4例浸润颅底骨髓,2例破坏硬腭。MRI表现：T1WI低信号12例（与肌肉比较。以下同）。等信号8例;T2WI高信号11例,等信号9例;病变轻度强化6例,中度强化10例。4例沿翼腭窝神经周扩散。结论 多数鼻腔淋巴瘤及弥漫型鼻腔鼻窦淋巴瘤有特异影像学征象,可提示诊断;鼻窦淋巴瘤则缺乏特异影像学征象。CT是本病诊断的主要影像检查方法,MRI能更清楚显示病变的范围。帮助临床准确地分期。     

Computed tomography in the evaluation of cutaneous T-cell lymphoma

The computed tomography (CT) scans performed in 28 patients with cutaneous T-cell lymphoma (CTCL) were reviewed. Fifteen patients had clinically advanced cutaneous mycosis fungoides, six patients Sézary syndrome and seven variant CTCL. Of the 40 scans available 12 were normal, 15 indeterminate and 13 abnormal. Indeterminate and abnormal nodes showed a predilection for inguinal and axillary sites with a relative sparing of deep nodal regions. Visceral involvement was infrequent. In six patients CT detected abnormalities not obvious clinically and upstaged the disease. CT should be performed as part of the initial staging and as a baseline for follow-up in patients with advanced mycosis fungoides, Sézary syndrome and variant CTCL.     

原发性脑淋巴瘤的影像学表现与病理学对照研究

目的:探讨原发性脑淋巴瘤的CT、MRI表现特征及病理基础。方法:回顾性分析9例经病理证实的原发性脑淋巴瘤的CT、MRI资料,并与病理资料进行对照分析。结果:9例中4例为单发,5例多发,共有15个病灶,幕上13例,幕下2例,其中位于脑室旁深部白质的病灶7个,占46.6%,位于脑表面及灰白质交界区4个,占26.6%,位于小脑部2个,占13.3%。原发性脑淋巴瘤的影像学形态多为类圆形肿块或结节,瘤周多为轻中度水肿。CT平扫表现为等或稍高密度,增强扫描呈团块状、结节状均匀强化;MR平扫T1WI等或稍低信号,T2WI呈高信号;增强扫描显示病灶呈团块状或结节状均匀性明显强化。病理上肿瘤细胞均呈弥漫密集分布,瘤细胞大小较一致,胞质及水分少,核大,染色质颗粒粗,可见瘤细胞围绕血管呈袖套样浸润,未见明显的出血及坏死,亦未见钙化。网状纤维染色显示纤维结构较丰富,此种病理组织学特点决定了淋巴瘤具有一定的影像学特点。结论:原发性脑淋巴瘤的病理学基础决定其CT、MRI表现特征,结合其影像学表现和临床资料多可做出正确诊断。     

Radiographic findings of primary B-cell lymphoma of the stomach: low-grade versus high-grade malignancy in relation to the mucosa-associated lymphoid tissue concept

OBJECTIVE: We undertook this study to assess how well double-contrast radiography and CT allow radiologists to differentiate low-grade from high-grade mucosa-associated lymphoid tissue (MALT) lymphoma of the stomach. MATERIALS AND METHODS: We retrospectively reviewed the upper gastrointestinal radiographs and contrast-enhanced CT scans of 57 patients with pathologically proven primary gastric lymphoma (low-grade [n = 29] and high-grade [n = 28] MALT lymphoma). RESULTS: On upper gastrointestinal radiography, ulceration (39%) was the most common finding in low-grade lymphoma, whereas polypoid appearance (38%) was the most common in high-grade lymphoma. In the 29 patients (33 lesions) with low-grade MALT lymphoma, upper gastrointestinal radiography revealed 13 ulcerative lesions (39%), 10 nodular lesions (30%), four infiltrative lesions (12%), two polypoid lesions (6%), and four combined lesions (12%). In the 28 patients (29 lesions) with high-grade lymphoma, upper gastrointestinal radiography revealed 11 polypoid lesions (38%), nine infiltrative lesions (31%), six ulcerative lesions (20%), one nodular lesion (3%), and two combined lesions (7%). On CT, thickening of the gastric wall in low-grade lymphoma (range, 0.3-2.5 cm; mean, 0.8 cm) was much less than that in high-grade lymphoma (range, 0.7-8.0 cm; mean, 2.5 cm). Abdominal lymphadenopathy was less frequent in low-grade lymphoma (14%) than in high-grade lymphoma (75%). CONCLUSION: Most low-grade lymphomas show superficial spreading lesions, such as mucosal nodularity, shallow ulcer, and minimal fold thickening, on upper gastrointestinal radiography, whereas most high-grade lymphomas show mass-forming lesions or severe fold thickening.     

Determination of renal arterial stenosis severity: comparison of pressure gradient and vessel diameter

PURPOSE: To evaluate radiologic findings of peripheral T-cell lymphoma (PTCL) of the colon at double-contrast barium enema examination. MATERIALS AND METHODS: Double-contrast barium enema findings in six patients with pathologically proved PTCL of the colon were retrospectively evaluated and compared with colonoscopic and histopathologic findings. RESULTS: There was a diffuse involvement of almost all segments of the colon in four patients and a focal segmental involvement in two. Frequent findings at double-contrast barium enema examination included geographic ulcerations (n = 6), aphthous ulcerations (n = 4), pseudopolyps (n = 4), circumferential luminal narrowing (n = 4), and ileocecal deformity (n = 4). CONCLUSION: PTCL of the colon manifested as either a diffuse or a focal segmental lesion and showed extensive mucosal ulceration at double-contrast barium enema examination. These findings are similar to those of inflammatory bowel disease and are different from those of colorectal lymphoma with the B-cell phenotype.     

全身MRI与PET/CT在淋巴瘤骨髓浸润诊断及预后中的作用

淋巴瘤是一种血液系统恶性肿瘤。淋巴瘤骨髓浸润(BMI)使疾病分期上升至IV期, 是疾病进展、预后较差的标志。常规部位的骨髓活检(BMB)具有创伤性, 且检出率低。PET/CT与全身MRI的出现, 丰富了BMI的检测手段。PET/CT与全身MRI对于淋巴瘤, 尤其是侵袭性淋巴瘤BMI均具有较高的检出率, 二者孰高孰低, 尚未定论。对于红骨髓、良性骨髓病变(炎症等)、淋巴瘤BMI病灶以及肿瘤治疗后骨髓的变化与骨髓残留或复发病灶, 全身MRI很难区分, 而PET/CT却可以很好地鉴别这些病灶。但是, PET/CT存在电离辐射; 对于惰性淋巴瘤的BMI, 超出PET/CT分辨率的病灶, 可能出现假阴性; 某些情况会限制PET/CT的使用, 包括18F-FDG生理性摄取量可能发生改变的正常组织、18F-FDG摄取相关性炎症、高血糖或高胰岛素血症导致的18F-FDG分布的改变、肿瘤患者治疗后出现的骨髓活化等。然而, 这些情况可以使用全身MRI。因此, 全身MRI和PET/CT相辅相成, 优势互补, 但二者均不能代替BMB。对于常规BMB阴性, 但影像学提示阳性的患者, 在影像学引导下进行BMB, 可以提高BMI的检出率。另外, 全身MRI阳性的淋巴瘤BMI患者与全身MRI阴性的淋巴瘤BMI患者相比, 前者预后可能较差。     

Computed tomography features of primary pulmonary non-Hodgkin's lymphoma.

AIM: To characterize computed tomography (CT) features of primary pulmonary lymphoma (PPL). METHODS: The CT films of six patients (five men, one woman; 63.2 +/- 14.5 years) with low grade non-Hodgkins PPL were evaluated for alveolar opacities (lobar consolidation, masses or nodules, and ill-defined consolidations), peribronchial disease or bronchial wall thickening, mediastinal nodes and pleural effusion. RESULTS: Multilobar bilateral, multilobar unilateral, and unilobar unilateral involvement were present in three, one and two cases respectively. CT features were: ill-defined mainly subpleural consolidations (n = 4), mass-like consolidation (n = 1), lobar consolidation (n = 1), and pleural effusion (n = 1). Minor peribronchial disease was seen in two patients, heterogeneous enhancement in four patients, and CT-angiogram sign in one patient. There were no lymphadenopathy or lung nodules. Although the pleura were inseparable from subpleural disease, pleural enhancement was noted on magnetic resonance imaging (MRI) of a patient with lobar lymphoma. CONCLUSION: PPL is characterized by ill-defined alveolar opacities that are usually multifocal. Peribronchial disease, proximal bronchiectasis and positive CT-angiogram sign are ancillary features. MRI may be useful in further evaluation with respect to pleural or chest wall involvement.     

Thoracic CT findings of adult T-cell leukemia or lymphoma

OBJECTIVE: The aim of this study was to assess pulmonary CT findings in patients with adult T-cell leukemia or lymphoma. MATERIALS AND METHODS: We retrospectively reviewed CT scans of the lung in 87 patients with adult T-cell leukemia or lymphoma who had undergone chest CT between January 1996 and March 2002 at two institutions. The CT scans were interpreted by two chest radiologists working in consensus. Parenchymal abnormalities (ground-glass attenuation, consolidation, nodules, thickening of bronchovascular bundles, interlobular septal thickening, honeycombing, crazy-paving appearance, and bronchiectasis) were evaluated, as were enlarged lymph nodes, pleural effusion, and pleural thickening. In 46 patients who underwent surgical biopsy or autopsy, CT-pathologic correlation was performed with the actual specimens by a pathologist and two chest radiologists. RESULTS: On the CT scans, abnormal findings were seen in 60 patients (69.0%). CT findings consisted of ground-glass attenuation (n = 37), centrilobular nodules (n = 25), thickening of bronchovascular bundles (n = 22), and consolidation (n = 13). These abnormalities were predominantly seen in the peripheral lung parenchyma (n = 26). Pathologically, these findings corresponded with atypical lymphocyte infiltration along the interstitium and the alveolar spaces. Pleural effusion and enlarged lymph nodes were found in 22 and 27 patients, respectively. CONCLUSION: CT findings in patients with adult T-cell leukemia or lymphoma consisted mainly of ground-glass attenuation, centrilobular nodules, and thickening of the bronchovascular bundles in the peripheral lung. These findings, although nonspecific, are considered suggestive of thoracic involvement in patients with adult T-cell leukemia or lymphoma.     

Dynamic contrast enhanced perfusion MRI in mycosis fungoides

Mycosis fungoides is a malignant, cutaneous lymphoma of T-helper (TH or CD4+) cells. At presentation, the disease is usually limited to the skin, with lesions that resemble eczema or psoriasis. Neurologic involvement is uncommon. This case demonstrates the conventional MRI and dynamic contrast enhanced perfusion MRI findings in intracerebral mycosis fungoides. T1-weighted spin echo imaging demonstrated a lesion with slightly decreased signal within the body of the corpus callosum. The lesion was isointense with grey matter on axial T2-weighted imaging. Following administration of contrast, there was patchy heterogeneous enhancement. Multiple relative cerebral blood volume (rCBV) measurements were made and the minimum rCBV was 0.30 with the maximum rCBV being 1.61. The mean rCBV was 0.81 +/- 0.49 (average of 10 measurements and standard deviation).     

骨非霍奇金淋巴瘤影像诊断

目的 :探讨骨非霍奇金淋巴瘤影像表现及诊断要点。方法 :回顾性分析 2 0例经临床和病理确诊的非霍奇金淋巴瘤病例的X线、CT及MR表现。结果 :骨原发性非霍奇金淋巴瘤 13例 ,继发性 7例 ;B细胞源性 18例 ,T细胞源性 1例 ,组织细胞性 1例。 14例侵犯单骨 ,6例侵犯多骨 ,共侵犯 2 9个骨骼 ,其中骨盆 10例次 ( 10 / 2 9) ,股骨 6例次 ( 6/ 2 9) ,脊柱6例次 ( 6/ 2 9)。X线及CT表现为溶骨型 6例 ,浸润型 4例 ,硬化型 1例 ,混合型 7例 ,囊状膨胀型 2例。 6例MRI检查 4例呈长T1、长T2 信号 ,1例呈中等混杂T1、长T2 信号 ,1例呈等T1、混杂T2 信号 ,增强后均呈斑片状不均匀强化。骨皮质广泛破坏及中断 8例 ,筛孔样破坏 4例 ,皮质完整 8例。全部有软组织肿块 ,14例呈环形 ,包绕病骨生长 ,并超越骨病变的范围 ,3例呈梭形 ,3例呈局限性。 7例有骨膜反应 ,5例合并病理性骨折。结论 :本病最常发生于骨盆、股骨及脊柱 ,多侵犯单骨 ,亦可多骨发病 ,常表现为浸润性、溶骨性及混合性骨破坏。骨破坏范围广泛 ,骨皮质破坏较轻或完整 ,巨大软组织肿块 ,并包绕病骨周围生长是其影像学特点 ,可能与肿瘤细胞产生的细胞因子有关 ,后者可控制广泛的破骨活性。诊断需密切结合临床和病理。     

Prospective study of bone marrow infiltration in aggressive lymphoma by three independent methods: whole-body MRI, PET/CT and bone marrow biopsy

PURPOSE: Initial lymphoma staging requires bone marrow assessment in aggressive lymphomas. Bone marrow lymphoma infiltration is routinely assessed by bone marrow biopsy (BMB), considered as the "gold standard". The aim of this study was to compare the performance of BMB, whole-body MRI and PET/CT for evaluation of BM infiltration. METHODS: Patients with newly diagnosed aggressive lymphoma were evaluated by BMB, MRI and PET/CT. Two radiologists, two nuclear medicine physicians and one pathologist independently assessed the results of the three modalities. Bone was considered as involved if BM was positive or if PET/CT or MRI was positive and if there was a resolution of the abnormal image shown on PET/CT or MRI halfway or at the end of therapy. RESULTS: Both MRI and PET/CT detected bone marrow lesions in the 9/43 patients, but two patients with multiple lesions had more lesions detected by PET/CT compared to MRI. Among these nine patients, two with an iliac crest lesion detected by both MRI and PET/CT had bone marrow involvement with large-cell lymphoma on histological examination. The other seven patients had focal MRI and PET/CT lesions in areas other than the iliac crest, where the blind BMB was done. The other patients had bone marrow without large-cell lymphoma involvement. In all cases, after lymphoma therapy bone marrow involvement regressed on histological examination, PET and MRI. CONCLUSION: These preliminary results suggest that non-invasive morphological procedures could be superior to BMB for bone marrow assessment in aggressive lymphomas. Ongoing study is underway to validate these results.     

Bilateral breast involvement in Sézary syndrome

Cutaneous T-cell lymphoma is a term used for mycosis fungoides and Sézary syndrome, the distinct clinical entities where the skin is the primary organ of involvement. Sézary syndrome is the leukemic variant of mycosis fungoides, presenting with generalized erythroderma, lymphadenopathy, and atypical cells (the Sézary cells) in the peripheral blood and bone marrow. The dissemination of cutaneous T-cell lymphoma may occur with no exception of the organs; however, no prior report exists about the Sézary syndrome secondarily involving the breasts. We report the clinical and radiological findings of bilateral breast involvement in a case of Sézary syndrome.     

软骨母细胞瘤的影像学表现及对比研究

目的分析对比软骨母细胞瘤的X线、CT及MR影像学特征。方法分析经病理证实且于2周内行X线、CT和MR检查的22例软骨母细胞瘤病人的影像学表现。2例同时行CT平扫和增强扫描,7例同时行MR平扫和增强扫描。结果病灶位于胫骨上端11例,股骨下端4例,髌骨2例,肱骨上端、股骨上端、颞骨和下颌骨各1例。1例恶性者发生于髂骨并同时累及骶骨。X线表现为骨质破坏(21),病灶内斑片状、斑点状和(或)条状致密影(5),病灶周围边界不清的斑片状硬化(10)。CT上,病灶呈类圆形分叶状(14),内为软组织密度(7),伴有斑片状、斑点状和(或)结节状钙化(15),病灶周围出现边界不清的斑片状硬化(15),病变周围软组织肿胀(18)。病灶在T2WI和脂肪预饱和T2WI均呈混杂信号(22),病灶周围髓腔内有边界不清的斑片状长T1长T2信号(20)。结论良性软骨母细胞瘤的影像学表现多具有特征性,X线平片、CT和MRI多数征象相互对应。     

免疫状态正常人原发性中枢神经系统恶性淋巴瘤的CT、MRI特征(附26例报告)

目的:探讨CT和MRI对免疫状态正常人原发性中枢神经系统恶性淋巴瘤的诊断价值。方法:对26例经手术和病理证实的脑内淋巴瘤的CT和MRI影像学表现进行回顾性分析。结果:26例患者共发现病灶39个,病灶除分布于额叶、颞叶、基底节等常见部位外,还可见于胼胝体、视交叉和松果体区。CT平扫:95%的病灶呈等或高密度,82%呈均匀密度。MRI:T1WI呈等或稍低信号病灶占90%,T2WI呈等或稍高信号病灶占100%。多数瘤灶呈轻至中度周围水肿(82%)和占位效应(82%)。CT和MRI增强扫描多为均匀强化。结论:脑内原发淋巴瘤少见,影像学表现与颅内其它肿瘤互相重叠,CT和MRI平扫和增强扫描的应用有助于脑内淋巴瘤的诊断和鉴别诊断。     

脊柱区淋巴瘤的MRI特征

目的 分析脊柱区淋巴瘤的MRI表现,以提高对其的认识.方法 回顾性分析经手术及穿刺病理或临床随访证实的脊柱区淋巴瘤45例,其中原发性5例,均为非霍奇金淋巴瘤(NHL);继发性4|D例,其中霍奇金淋巴瘤(HL)9例,NHL 31例(B细胞型27例,T细胞型4例).将MRI表现与临床、病理结果进行对照.结果 (1)病变部位:单部位发病者13例,多部位发病者32例.5例原发性者均为单部位发病,继发性者40例中32例为多发.(2)病变类型:骨质破坏型27例,表现为不同程度的骨质破坏,23例合并有软组织肿块,18例软组织病变的范围超过骨质破坏的范围;软组织肿块型6例,骨质破坏不明显,5例表现为椎管内外软组织肿块并经椎间孔相连,呈围椎、钻孔生长的特点;骨髓浸润型9例,表现为椎骨髓质MRI信号异常,骨皮质完整,椎旁软组织正常;脊髓浸润型3例,表现为脊髓增粗和MRI信号异常.(3)MRI表现:椎骨骨质破坏和骨髓浸润表现为T1WI低信号,T2WI低、等或高信号,压脂T2WI高信号.软组织肿块与相邻正常肌肉相比,T1WI呈均匀低信号,T2WI呈高信号.增强扫描肿块多呈轻至中度强化,坏死液化不明显.结论 脊柱区淋巴瘤多为继发性B细胞NHL,其主要表现是溶骨性骨质破坏伴较大范围的软组织肿块,肿块有经椎间孔相连围椎、钻孔生长的特点,增强扫描呈轻至中度均匀强化.     

上颌骨动静脉畸形的影像学特点

目的：研究上颌骨动静脉畸形（AVM）的X线、CT及MRI表现。方法对17例上颌骨AVM进行增强CT检查,其中3例行曲面断层X线检查,6例行增强MRI检查。结合血管造影（DSA）检查,分别观察病变部位、形态、边界、内部结构、邻近结构侵犯以及增强后密度／信号特征。结果病灶主要位于磨牙区（15／17）,临床以上颌牙龈反复渗血或急性出血者常见,其他表现包括脸部肿胀或搏动性肿物、脸部麻木。X线上主要表现为病灶部位的密度增高。增强CT上根据颌骨的改变可大致分为2类：Ⅰ类,膨胀性及溶骨性骨质破坏（n＝12）;Ⅱ类,弥漫性骨小梁增粗,类似“磨砂玻璃”样改变（n＝5）。17例患者均有不同程度的骨质破坏及周围软组织侵犯、可见供血动脉稍增粗或增粗迂曲的回流静脉、上颌窦腔不同程度抬高;14例患侧颈外静脉（或其他回流静脉）增宽或提前显影;牙根吸收者6例。M RI上Ⅰ类主要表现为不同程度流空效应,Ⅱ类主要表现为T1 WI等低信号,T2 WI高信号,增强后明显强化。结论增强CT扫描能显示颌骨AVM病灶范围及血管侵犯情况,可为首选检查。     

骨原发性淋巴瘤的CT、MRI表现

目的探讨骨原发性淋巴瘤的CT、MRI表现。方法回顾性分析19例骨原发性淋巴瘤的CT、MRI影像资料,并结合文献及病理分析。结果19例均为单骨发病,脊柱10例,骨盆6例,股骨3例。骨质均呈侵润性破坏,CT呈斑片状、虫蚀状溶骨性破坏,MRI呈稍长T1、T2信号（抑脂序列）,内可伴更长T1信号,周围均伴软组织病灶且范围多大于骨内病灶。CT增强3例中软组织病灶明显均匀强化1例、轻度均匀强化2例。MRI增强15例中骨内病灶明显强化12例,其中呈“镶边征”10例,轻度强化3例;周围软组织病灶明显强化9例,伴坏死2例,轻度至中度均匀强化6例。病理上均为B细胞源性,且多为弥漫性大B细胞淋巴瘤。结论骨原发性淋巴瘤的CT、MRI表现有一定的特征性,MRI对PLB定性诊断有较高的诊断价值,结合好发部位及年龄,应考虑到PLB的可能性。     

原发性脑内恶性淋巴瘤的CT、MRI诊断

目的 探讨原发性脑内恶性淋巴瘤的CT、MRI表现特征。资料与方法 回顾性分析11例经病理证实的原发性脑内恶性淋巴瘤的CT、MRI资料(其中4例同时进行CT、MRI扫描，1例仅有CT资料，6例仅有MRI资料)，并与病理资料进行对照分析。结果 11例中10例为单发，1例多发，共有12个病灶，其中位于脑室旁深部白质的病灶4个，占33．3％，位于脑表面及灰白质交界区有7个，占58．3％，位于小脑部1个，占8．4％。原发性脑内恶性淋巴瘤的影像学形态多为类圆形肿块或结节，瘤周水肿及占位效应较轻。5例病变CT平扫表现为等或略高于脑组织密度影，无出血和钙化，注射对比剂后呈团块状或结节状均匀性强化；10例MR平扫中，T1WI上9个病灶呈等信号或略低信号，其余2个病灶呈低信号；在T2WI上，8个病灶呈等信号，3个呈略高信号，增强扫描显示病灶呈团块状或结节状均匀性明显强化。病理上肿瘤细胞均呈弥漫密集分布，瘤细胞大小较一致，胞质及水分少，核大，可见瘤细胞围绕血管呈袖套样浸润，未见明显的出血及坏死，亦未见钙化，网状纤维染色显示纤维结构较丰富，此种病理组织学特点决定了淋巴瘤具有一定的影像学特点。结论 原发性脑内恶性淋巴瘤的病理学基础决定其CT、MRI表现特征，结合其影像学表现和临床资料多可做出正确诊断。