局限型巨大淋巴结增生症的影像学表现

目的探讨巨大淋巴结增生症（CD）的影像学表现特点,旨在提高对该病的诊断水平。方法回顾分析13例CD的超声、CT及MRI表现,结合临床、手术病理资料及文献复习。结果 13例中位于颈部6例（左右各3例）、位于纵膈2例、左颌下、左锁骨上窝、左腋窝、腹膜后及左腹股沟区各1例,病灶直径2.5cm至8.4cm不等。颈部1例及左腹股沟区病灶多发,其余单发。7例超声检查表现为非均质低回声团块,边界清晰,血流丰富。4例CT平扫呈类圆形或卵圆形,边界清楚,平扫1例密度均匀,2例可见斑点状、分支状钙化,1例可见低密度区;增强扫描病灶均强化明显,腹膜后肿块动脉期及门静脉期均明显强化,纵膈及腹膜后病灶增强扫描可见斑片状低密度轻度强化或无强化区。2例MRI平扫T1WI呈等或稍低信号,T2WI高信号（与胸锁乳突肌信号比较）,信号均匀,增强扫描明显均匀强化。结论巨大淋巴结增生症的超声、CT及MRI表现有一定的影像学特征,尤其CT及MRI表现具有较高的诊断价值。

Imaging Manifestations of Localized Castleman Disease

Objective To explore imaging characteristics of castleman disease(CD)and improve the diagnostic level to this disease.Methods The ultrasonography,CT and MRI manifestations of 13 cases with CD were retrospectively analyzed combined with their clinical manifestations,surgical pathology and literatures.Results In these cases,focuses of 6 cases were at the cervical part and 3 cases on each side.2 cases were at mediastinum.1 case was at left submandibular region,left supraclavicular fossa,left axillary fossa,retroperitoneal lacuna and left inguinal region respectively.Diameters of focuses were from 2.5 to 8.4 cm.The focuses of 1 case at the cervical part and 1 case at the inguinal region were multiple,but focuses at other parts were solitary.Ultrasonography was performed to 7 cases and the images showed inhomogeneous and hypoechoic lump which had clear edge and rich blood flow.CT scanning was performed to 4 cases and images showed oval focuses which had well-defined edges.Plain CT scanning showed homogeneous density in 1 case,stippled or cladodromous calcification in 2 cases and low density area in 1 case.The enhancement scanning showed that the focuses were enhanced obviously.The retroperitoneal lumps were enhanced obviously in arterial phase and portal venous phase.The enhancement scanning of focuses at mediastinum and retroperitoneal lacuna showed that the stippled low density regions were slightly enhanced or not enhanced.MRI scanning showed the same or slightly low signal intensity in T1WI and high signal intensity in T2WI(compared to the signal intensity of sternocleidomastoid)and the signals were homogeneous.The enhancement scanning showed homogeneous enhancement.Conclusions The ultrosonography,CT and MRI manifestations of castleman disease have certain imaging characteristics,and CT and MRI manifestations have high diagnostic values in particular.