磁共振检查对脾脏淋巴瘤的诊断价值

目的探讨磁共振检查对脾脏原发性淋巴瘤（PSL）的诊断价值。方法经手术病理证实的脾脏PSL患者3例，均采用磁共振检查，分析其影像学表现及诊断情况。结果3例手术后病理诊断均为B细胞型非霍奇金淋巴瘤，磁共振检查表现为多发肿块型2例，巨块型1例；磁共振平扫表现为脾脏不规则增大，呈等／稍长T1稍短T2信号巨大肿块影像，脾周围见线样长T1、长T2信号，脾门血管被包绕；增强扫描后，脾脏病变不均匀强化，呈等、低混杂信号，腹膜后病变呈中等均匀强化。免疫组化提示弥漫大B细胞型2例，肿瘤细胞CD20及CD19α弥漫（＋）、CD3、CD5散在（＋）、CD43（＋）、CD45RO（＋）、CD10（＋／-）、Mum（＋）、MAC387散在（＋），B系淋巴浆细胞型1例，CD79eL（＋）、CD23（＋）、CD38（＋）、λ（＋）。结论PSL的磁共振表现具有特征性，有助于明确诊断，确诊依靠手术病理和免疫组化检查。

The value of MR in the diagnosis of primary splenic lymphoma

Objective To evaluate the value of MR in the diagnosis of primary splenic lymphoma (PSL).Methods The MR imaging features of 3 PSL cases proved by pathology were retrospectively reviewed. Results Three cases were all pathologically diagnosed as B-cell non-Hodgkin's lymphoma(NHL). Two cases were multiple node shape and one was massive shape. Unenhanced MR imaging revealed heterogeneous splenic enlargement, with large nodules showing iso-hyperinternse on T1WI and hypointense on T2WI. Linear hyperintense on T1WI and T2WI was seen on the spleen peripherous. The spleen vascular was infiltrated. CE-MRI showed heterogeneous enhancement of spleen with iso-hypointense. The focus of postperitoneal showed medial enhancement. Immunohistochemistry-showed 2 cases of diffuse B cell. The CD20 and CD19 α of tumor cell showed diffuse( + ) ,CD3 ,CD5 individual( + ) ,CD43 ( + ) ,CD45RO( + ), CD10 ( +/- ), Mum ( + ), MAC387 individual ( + ), 1 case of B lymphocell type, CD79α ( + ) ,CD23( + ) ,CD38( + ) ,λ( + ). Conclusion The MR imaging features of PSL were characteristic and helpful in the diagnosis of PSL, but the correct diagnosis was still dependent on the pathology and immunohistochemical staining.