腹部恶性淋巴瘤的CT诊断报告

目的:探讨腹部恶性淋巴瘤的CT影像诊断特点,及时作出诊断及鉴别诊断。方法:搜集经手术或病理证实的腹部恶性淋巴瘤4 3例,其中何杰金病(HD) 4例,非何杰金淋巴瘤(NHL ) 39例,全部进行CT增强扫描。结果:累及腹部淋巴结的39例,75 .0 %HD和82 .1 %NHL淋巴结增大呈普遍均匀强化密度,2 5 .0 %HD和1 7.9%NHL呈均匀强化合并坏死密度。HD和NHL 累及小网膜(30 .2 %)、肠系膜(2 5 .6 %)、胰腺周围(5 1 .2 %)、腹主动脉周围(79.1 %)。7例胃肠恶性淋巴瘤均示胃肠壁不规则增厚,3例伴淋巴结增大。NHL 中1 8例脾增大,1 5例呈均匀密度增大,3例有占位征象。结论:CT检查能较好显示腹部恶性淋巴瘤淋巴结及结外器官病理改变、病变范围,对恶性淋巴瘤的诊断及其临床的分期及疗效的判定有较高价值。

Computed Tomographic Diagnosis of Malignant Lymphoma of the Abdomen

Objective to investigate CT manifestation of abdomen malignant lymphoma and help doctors make a diagnosis and differential diagnosis.Methods Forty-three cases of abdominal malignant lymphoma proved with pathology were studied,including 4 cases of Hodgkin's disease (HD) and 39 cases of non-Hodgkin's lymphoma (NHL).Enhanced CT scanning was performed with a Siemens scanner in all patients.Results Involvement of the abdominal lymph nodes was found in 39 cases. The CT scan revealed the diffuse enlarged lymph nodes with homogeneous enhancement density in 75.0 % HD and 82.1 % NHL,while the enlarged lymph nodes with homogeneous enhancement and necrosis density were detected in 25.0 % HD and 17.9 % NHL.Both HD and NHL affected the lymph nodes of the lesser omentum(30.2 %),mesentery(25.6 %),peripancreatic area(51.2 %),and near the abdominalaorta (79.1 %). All 7 patients with gastrointestinal lymphoma were found the wall of the gastrointestinal irregularly thickened,but only 3 of them were detected the enlarged lymph nodes.18 cases of the patients with NHL were found Splenomegaly, 15 of them with homogeneous density, and another 3 cases with a space-occupying effect.Conclusion CT can easily demonstrate the involvement and extension of the lymph nodes and other abdominal organ in patients with abdominal malignant lymphoma, which is very useful for making a diagnosis, determining tumor stage and evaluating therapeutic effect.