原发性肾上腺淋巴瘤影像学表现及其病理相关性

目的 探讨原发性肾上腺淋巴瘤（PAL）的CT、MRI表现及其与病理学的相关性。方法 回顾性分析经病理证实的13例PAL的CT、MRI表现，均为弥漫大B细胞型非霍奇金淋巴瘤，其中3例经手术证实，10例经穿刺活检证实；其中8例乳酸脱氢酶（LDH）升高。11例（18个病灶）接受CT检查，6例（11个病灶）接受MR检查，4例同时接受CT和MR检查。结果 9例为双侧病灶，4例单侧病灶，共22个病灶。病灶最大径为2.60~13.40 cm，16个病灶呈类圆形、椭圆形，2个呈不规则形，4个基本保持肾上腺形状。18个病灶CT平扫呈软组织密度影，9个病灶MR T1WI呈低信号、T2WI呈稍高信号。CT或MR增强扫描中，病灶均呈轻中度渐进性均匀或不均强化，其中4个在MR增强静脉期或延迟期出现网格状强化。结论 PAL影像学表现具有一定特征性，结合LDH检查可提高术前正确诊断率。

Imaging findings of primary adrenal lymphoma and correlation with pathology

Objective To explore CT, MRI manifestations of primary adrenal lymphoma (PAL) and their correlation with pathology. Methods CT and MRI findings of 13 patients of PAL confirmed by pathology were analyzed retrospectively, among them 3 cases were confirmed by surgical operation and 10 cases by puncture biopsy, all 13 cases were diffuse large B-cell non-Hodgkin''s lymphoma. The level of lactate dehydrogenase (LDH) increased in 8 cases. CT was performed in 11 cases (18 lesions), MR in 6 cases (11 lesions), and both CT and MR in 4 cases. Results There were 22 lesions in 13 cases, 9 cases with bilateral lesions and 4 cases with unilateral lesions. The maximum diameter of the lesions was 2.60-13.40 cm. Sixteen lesions were round and oval shaped, 2 in irregular shape and 4 in adrenal shape. Eighteen lesions showed soft tissue density on CT, 9 lesions showed low signal intensity on MR T1WI and slightly high signal intensity on T2WI. CT or MR enhanced scan showed mild to moderate progressive homogeneous or uneven enhancement, of which 4 lesions showed grid enhancement in the venous phase or delayed phase of MR enhancement. Conclusion PAL has certain imaging characteristics. Combined with the level of LDH can improve diagnostic accuracy of PAL before surgical operation.