鼻腔T/NK细胞型淋巴瘤的影像学诊断

目的探讨鼻腔T/NK细胞型淋巴瘤的CT和MRI特点。方法回顾性分析35例经组织学证实鼻腔T/NK细胞型淋巴瘤的影像学资料。结果根据病变的范围分为局限型和弥漫型2种类型。CT表现:局限型25例,位于鼻腔前部23例,后部2例,向前浸润鼻前庭、鼻翼、鼻背及邻近面颊部皮肤23例;病灶密度均匀8例,不均匀17例,增强后低度强化6例,中度强化3例;中下鼻甲、鼻中隔轻微浸润性破坏2例。弥漫型10例,表现为鼻腔中线区骨质破坏伴软组织肿块,9例侵犯邻近鼻窦及面颊部软组织,6例蔓延到眼眶、颞下窝、翼腭窝,4例浸润颅底骨髓,3例破坏硬腭。MRI表现:T1WI低信号5例(与肌肉比较,以下同),等信号3例;T2WI高信号6例,等信号2例;病变低度强化2例,中度强化4例。3例沿翼腭窝神经周围蔓延。结论大多数鼻腔T/NK细胞型淋巴瘤有特征影像学征象,可提示诊断。

CT and MRI Diagnosis of T-cell/Natural Killer Cell Lymphoma in Nasal Cavity

Objective To study the CT and MRI features of T-cell/natural killer cell lymphoma in nasal cavity.Methods All 35 cases of T-cell/natural killer cell lymphoma were confirmed by pathology.Imaging data were analyzed retrospectively.Results The lesions were divided into localized and diffuse types according to the extent of tumors.On CT,the localized lesions were found in the anterior nasal cavity in 23 cases and in posterior part in 2 cases.Lymphoma anteriorly invaded nasal vestibule,nasal ala,nasal dorsum and adjacent cutaneous tissue in 23 cases.The lesions showed homogeneous density in 8 cases and inhomogeneous density in 17 cases.Postcontrast CT showed mild enhancement in 7 cases and moderate enhancement in 5 cases.The middle and inferior turbinates,nasal septum revealed slightly infiltrative bony destruction in only 2 cases.Diffuse lymphoma revealed bony destruction in the midline of nasal cavity associated with soft tissue.Nine cases invaded adjacent sinuses and facial soft tissue.Six cases extended orbit infratemporal fossa and pterygopalatine fossa.Four cases infiltrated bony marrow in the skull base.The destruction of hard palate was seen in 3 cases.The lesions showed hypointense signal compared to adjacent muscle in 5 cases and isointense signal in 3 cases on MR T1WI.On T2WI,the lesions demonstrated hyperintense singal in 6 cases and isointense signal in 2 cases.Postcontrast MRI showed slight enhancement in 2 cases and moderate enhancement in 4 cases.Perineural spread along pterygopalatine fossa was found in 3 cases.Conclusion Most nasal T-cell/natural killer cell lymphoma has specific imaging manifestations,which may suggest the diagnosis.