头颈部淋巴瘤计算机体层摄影、磁共振成像影像特点及临床病理分析

 【摘要】 目的 探讨头颈部结内型及结外型淋巴瘤的计算机体层摄影（CT）与磁共振成像（MRI）影像特点及临床病理特点。方法 分析46例经手术病理或穿刺活检证实的头颈部淋巴瘤患者临床病理及CT、MRI资料，结合文献复习，评价头颈部淋巴瘤的影像特点及临床、病理特点。结果 46例中38例为非霍奇金淋巴瘤（NHL），8例为霍奇金淋巴瘤（HL）。结外型21例（45.65 %），包括原发鼻腔10例、咽环（Waldeyer环）7例、喉部2例、甲状腺及腮腺各1例，其中13例伴发颈部淋巴结转移；结内型25例（54.35 %），主要累及颈部Ⅱ～Ⅳ区淋巴结。Ann Arbor分期：Ⅰ期14例，Ⅱ期19例，Ⅲ期0例，Ⅳ期13例。根据病变形态分为4型：多发结节型25例，肿块型11例，弥漫肿胀型8例，溃疡坏死型2例。结论 头颈部淋巴瘤的CT、MRI影像表现有一定特点，影像检查对淋巴瘤的诊断、鉴别诊断及观察侵犯范围有一定临床价值。

Characteristics and clinical pathologic analysis of computed tomography, magnetic resonance imaging in the lymphoma of head and neck

Objective To explore the imaging and clinical pathological features of extranoda and intranoda lymphoma in head and neck characterized by computed tomography （CT） and magnetic resonance imaging （MRI）. Methods 46 malignant lymphotna patients were confirmed by surgery and pathology .The CT and MR images data were reviewed and analyzed in comparison with surgical and pathological results. Diagnostic value of the CT and MRI findings were analyzed. Results The subjects enrolled in this study including 38 cases of non-Hodgkin lymphoma（NHL）and 8 cases of Hodgkin Lymphoma（HL）. The pathoilogicalsites of extranodal lymphomas （45.65 %,21/46） included nasal （10 cases）, Waldeyer ring （7 cases）, throat （2 cases）, Thyroid（1 case） and parotid （1 case）. The lymph nodes metastases in the neck were obserzed in 13 cases of Extranodal lymphomas. Intranodal lymphoma in neck （54.35 %,25/46） involved all district lymph nodes especially Ⅱ-Ⅳ districts. According to the Ann Arbor staging,14 cases were Ⅰ staging, 19 cases Ⅱ staging, none Ⅲ staging, IV staging 13 eases. According tumor form, 21 cases were multinodulars, 12 eases mass type, 11 cases diffuse swelling type, 2 cases ulcer or necrotic type. Conclusion CT and MR images might indicate the location, morphology, stlrrounding tissue and lymph nodes metastases of malignant lymphoma in head and neck. Great value in clinical diagnosis and treatment is observed.