鼻腔鼻窦恶性肿瘤的CT表现

目的 探讨鼻腔鼻窦恶性肿瘤的CT特点.方法 回顾分析45例经病理证实鼻腔鼻窦恶性肿瘤的CT表现.结果 鼻腔鼻窦癌20例,多为密度不均匀肿块(14/20),直接侵犯腔内(34/20)及腔外结构(20/20)并形成软组织肿块;18例骨质破坏明显,可见骨壁碎裂、缺失,鼻面部软组织肿胀不常见(2/20).T细胞性淋巴瘤16例,多起源于鼻前庭(11/16),以混合表现为主(11/16),多数密度均匀(12/16),主要累及腔内结构(36/18),但鼻面部肿胀常见(8/16);骨质破坏不明显或轻微,5例可见骨质吸收.1例恶性神经鞘瘤和2例B细胞性淋巴瘤表现与癌肿相似.1例骨肉瘤病灶内可见骨样组织影.4例恶性黑色素瘤表现无特异性.结论 CT能有效观察鼻腔鼻窦肿瘤的病变范围并对良、恶性进行鉴别,对NHL等具有一定特征性的肿瘤能进行提示性诊断.

CT diagnosis of malignant tumor in nasal cavity and paranasal sinuses

Objective To explore the CT features of malignant tumor in nasal cavity and paranasal sinuses.Methods CT images of 45 patients with malignant tumor in nasal cavity and paranasal sinuses with pathological verification were retrospectively analyzed.Results Carcinoma located in nasal cavity and paranasal sinuses were 20 cases and most of lesions(14/20) appeared inhomogeneous mass.Adjacent structures in(34/20) or out of the cavity(20/20) were involved in the formation of tissue mass.Obvious bone destruction was found in lesions in 18 cases which featured by bone structure chips or defects,but the swelling of tissue around noses and check was not often showing(2/20).Sixty cases were T-cell lymphoma and most of lesions(11/16) arisen from nasal vestibule,mainly consisting of mixed type(11/16),density of multiple lesions(12/16)were homogeneous.The structure in cavity mainly involved(36/18),but the swelling of tissue around noses and check was often showing(8/16).All 5 cases T-cell lymphoma showed no or mild bone destruction showing bony absorption.One case of malignant schwannoma and 2 cases of B-cell lymphoma were similar appearances to carcinoma.One case of osteoid tissue was found in lesion of osteogenic sarcoma.CT signs were not characteristic in 4 cases malignant melanoma.Conclusion It is available to indicate the circumstances of tumor lesions and to identified diagnosis in nasal cavity and paranasal sinuses by CT.Some tumors as well malignant lymphoma in the nasal cavity and paranasal sinuses are relative characteristic on CT images,which can be diagnosed in some degree.