原发性睾丸淋巴瘤的MRI表现及其鉴别诊断

目的 分析原发性睾丸淋巴瘤(PTL)的MRI表现及其鉴别诊断。 方法 对10例PTL患者行MR平扫,对其中3例行MR增强扫描,扫描序列包括常规T1W及T2W、脂肪抑制T2W(T2W+FS),扫描方位为轴位、矢状位及冠状位,层厚2~4 mm,观察病变部位、大小、形态、信号及其与周围组织关系,并与手术病理结果对比。 结果 9例为单侧睾丸发病,1例为双侧睾丸发病;10例睾丸肿瘤均呈弥漫性占位,T1WI均呈等低信号,T2WI呈均匀低信号5例,4例呈以低信号为主的混杂信号,1例等高信号;睾丸鞘膜积液5例,附睾或精索受侵6例;弥漫性大B细胞淋巴瘤9例,NK/T细胞淋巴瘤(鼻型)1例。 结论 PTL的MRI表现有一定特征,结合临床病史有助于诊断和鉴别诊断。

Primary testicular lymphoma: MRI manifestations and differential diagnosis

Objective To analyze the MRI findings and differential diagnosis of primary testicular lymphoma (PTL). Methods Plain MR scanning was performed in 10 PTL patients, and 3 patients underwent enhanced MR scanning, including T1W, T2W and T2W with fat suppression sequence. Scanning position included sagittal, coronal and traverse, and slice thickness varied from 2 mm to 4 mm. The location, size, shape and signal of the lesions were observed and analyzed according to MRI of different scanning procedure and scanning position. MRI appearances were compared with the results of pathology and surgery. Results Nine PTL were unilateral and 1 was bilateral. All PTL showed as diffuse lesions, and were isointense on T1WI. On T2WI, the lesions showed homogeneous low signal intensity in 5 patients, mainly hypointense in 4 patients, and iso-high signal in 1 patient. Hydrocele was found in 5 patients, and tumor invading the epididymis or spermatic cord was noticed in 6 patients. Diffuse large B cell lymphoma was confirmed in 9 patients, while NK/T cell lymphoma in 1 patient. Conclusion MRI characteristics of PTL are distinctive in certain extent. Combining with clinical history contributes to the diagnosis and differential diagnosis of PTL.