原发性子宫淋巴瘤超声及临床病理特征

目的总结原发性子宫淋巴瘤临床、超声及病理特征。方法对9例2002年9月至2012年9月山西医科大学附属山西省肿瘤医院收治并经手术病理确诊为原发性子宫淋巴瘤患者的临床、超声及病理特征进行总结分析。结果 9例原发性子宫淋巴瘤临床及超声表现：（1）子宫体淋巴瘤3例,其中2例以无痛性盆腔肿块就诊,1例以子宫肌瘤近期明显增大就诊;超声显示3例子宫体均弥漫性增大,子宫内膜完整,肿瘤边界清晰,后方回声均增强。（2）宫颈淋巴瘤6例,患者均以接触性出血就诊,其中4例有阴道不规则出血;超声显示4例肿瘤内为极低均匀性回声,且肿瘤边界清晰,呈分叶状;1例边界不清晰。（3）彩色多普勒血流成像示：9例中8例肿瘤病灶内血流信号增多。9例子宫切除术后病理均诊断为子宫（宫颈）原发性弥漫大B细胞非霍奇金淋巴瘤。结论阴道不规则出血或接触性出血,超声显示子宫体弥漫均匀性增大,而子宫或宫颈内膜较完整,病灶边界清晰,内为均匀性极低回声,后方回声增强者为子宫（宫颈）淋巴瘤的临床超声特征,最终仍需由病理检查确诊。

Ultrasonographic, clinical and histopathological characteristics of primary uterus lymphoma

Objective To explore the ultrasonographic,clinical and histopathological characteristics features of primary uterus lymphoma.Methods The clinical,sonographic and histopathological characteristics of nine patients who were pathologically comfirmed as primary uterus lymphoma were analyzed.Results Among the nine cases of primary uterus lymphoma,three lesions were found in the uterine bodys and 6 were found in the cervixes.Two patients with uterine body lymphoma had painless pelvic masses and six patients with cervix lymphoma had contact bleeding,including irregular vaginal bleeding in four patients.In sonograms,six lesions showed remarkable hypoechogenicity with homogeneous internal echogenicity;the margins of most lesions were circumcribed;all lesions had posterior enhancement.In color Doppler flow imaging,abundant vascularities were detected in eight lesions.In the cases of uterine body lymphoma,all of the uterine bodys showed diffuse symmetrical enlargement without disruption of the endometria,while in five cases of cervix lymphoma,the tumors showed the shape of lobule.The pathological examination showed that all tumors were diffuse B-cell type non-Hodgkin lymphoma.Conclusions Primary uterus lymphoma has some clinical and ultrasonic features,including contact bleeding or irrgular vaginal bleeding,diffuse symmetrical enlargement of uterine body,complete endometria,remarkable hypoechogenicity,homogeneous echogenicity and posterior enhancement.Final diagnosis depends on the histopathology.