超声对腹部恶性淋巴瘤与转移性淋巴结肿大鉴别诊断的探讨

目的:通过回顾性分析发生在腹部的恶性淋巴瘤与转移性淋巴结肿大的声像图特征,探讨超声鉴别诊断要点。方法:超声检出131例腹部实性结节或肿块,对其中41例经病理证实的恶性淋巴瘤与90例经手术(原发癌灶)、穿刺活检病理证实的转移性淋巴结肿大进行对比,重点分析了8项声像图特征。结果:两组对比病灶的发生部位、大小、内部回声、边界是否清晰,均无明显差别;病灶有无包膜、融合现象、融合内部回声多呈蜂窝状,其内带状分隔境界清晰,发生部位是否多区域,均有明显的差别。结论:病灶多有包膜回声、融合现象、融合内部回声多呈蜂窝状,发生部位多区域,是腹部恶性淋巴瘤与转移性淋巴结肿大声像图主要鉴别点,能为临床选择治疗方案和预后提供依据,具有较大的临床价值。

Ultrasonography in the differential diagnosis of abdominal malignant lymphoma and metastatic lymphadenopathy

Objective: To investigate the ultrasonographic diagnosis of abdominal malignant lymphoma and metastatic lymphadenopathy, the sonographic features were analyzed retrospectively. Methods: One hundred and thirty-one patients with abdominal solid nodules or tumor were detected and divided into two groups. In group one there were 41 cases proved as malignant lymphoma pathologically, while in group two there were 90 cases proved as metastatic lymphadenopathy by operations and/or biopsy. Eight graphic items were assessed for comparison. Results: There were significant differences in having capsule, fusion aspect, honeycomb-like echo, and multiple striations within the fusion mass. But no differences were seen in the location, size, inside echo, and border. Conclusion: B ultrasonography plays an important role in differential diagnosis of the two conditions and can also provide the evidences for the selection of clinical therapeutic scheme and predict patients' prognosis. So, B ultrasonography has great clinical significance in diagnosing cancer patients with metastatic lymph nodes.