原发性中枢神经系统B细胞淋巴瘤的磁共振波谱和病理对照

目的:阐明原发性中枢神经系统B细胞淋巴瘤(PCNSL)的氢质子磁共振波谱表现,并与病理进行对照。材料和方法:10例病理证实的PCNSL行磁共振常规及二维多体素波谱俭查,分析肿瘤实质、瘤周区域以及对侧的谱线,并将肿瘤实质的波谱与病理对照。结果:PCNSL的波谱表现为Cho峰升高及NAA、Cr峰的降低,1.3ppm处升高的Lip峰。瘤体和瘤周区域在Cho/Cr、Ch/NAA上有显著差异;Cho/Cr在瘤周区域2、3之间存在显著性差异,在瘤周区域2和对侧之间存在差异而在瘤周区域3和对侧之间无差异;1例病灶在瘤周区域3以远处仍可见异常谱线。HE染色和KP-1染色显示:HE染色显示肿瘤细胞密集,细胞形态较为单一;KP-1染色显示含脂质组织细胞散在分布于肿瘤细胞间。结论:PCNSL对周围浸润达到肿瘤强化边缘外15mm处,这可能对淋巴瘤的治疗有意义,而Lip峰和脂质吞噬细胞有关。

Magnetic Resonance Spectrum - Pathologic Correlation in Primary Central Nervous System B- cell Lymphoma

Purpose:To evaluate the value of magnetic resonance spectrum(MRS)in primary central nervous system B cell lymphoma(PCNSL),pathology of tumor parenchyma was taken as comparison. Materials and Methods:Ten cases were given MR scans including routine and MRS scans.2D multi- voxel PRESS sequence with parameter TR/TE 1000/144ms was done without contrast enhancement.All cases were verified by post-operation pathology.Results:Spectrum of PCNSL in all cases are similar with Cho peak increased in the parenchyma while Cr and NAA peak decreased.Prominent peak of lipid can be seen in parenchyma.Significant difference can be seen in Cho/Cr between parenchyma and sur- rounding edematous region.No difference of Cho/Cr can be seen between the region 15mm away from the lesion and the contra-lateral region in the brain.HE stain of pathological section shows high density of lymph cell in tumor parenchyma.Histiocyte containing lipid can be seen scattered among lymph cell through KP-1 stain.Conclusion:The spectrum verified the infiltration of PCNSL.Lip peak may be concerned with histiocytes in tumor.