Castleman病CT影像特征

目的 探讨Castleman病的CT影像特征,提高对Castleman病的认识,减少术前误诊.方法 对13例经病理学证实为Castleman病的临床资料及CT影像资料进行回顾性分析.结果 局灶型9例,其中胸部4例(肺内2例,纵隔2例),腹部5例(腹腔1例、腹膜后4例);9例局灶型术后病理均为透明血管型.多中心型4例,分布于肺、腋窝及腹股沟.术后病理结果:透明血管型10例、浆细胞型1例、混合型2例.所有病例CT平扫均表现为软组织密度的肿块或结节,境界清楚,2例局灶型肿块内见斑点状、分支状钙化灶;增强扫描9例局灶型动脉期病灶均明显强化,延时期强化程度有减低,但呈持续强化,3例局灶型肿块周围见散在增大的淋巴结,病理证实为反应性淋巴结炎.4例多中心型表现无明显特征性,2例动脉期明显强化,2例轻-中度强化,1例延迟期强化较动脉期明显.结论 局灶型Castleman病以透明血管型多见,CT具有一定的特征性,表现为境界清楚的软组织密度肿块,动脉期明显强化、延迟期强化有减退,但呈持续强化,可伴有钙化及卫星灶;但多中心型Castleman病CT相对无明显特征.

CT Image Features of Castleman's Disease

Objective To explore the CT imaging features of Castleman's disease, and improve the awareness of Castleman's disease before surgery. Methods The clinical data and CT imaging data of 13 patients with pathologically proved Castleman's disease were analyzed retrospectively. Results Nine cases were localized with hyaline vascular type in pathological classification, including 4 cases in chest(2 cases in lung, 2 cases in mediastinum), 5 cases in abdomen(1 case in abdominal cavity and 4 case in retroperitoneum). Four cases were multicentric with lesions distributed in the lung, abdominal cavity, axillary and groin, and pathologically classified into hyaline vascular type in 1, plasma cell type in 10, and mixed type in 2.All lesions were of iso-density on plain CT with well-defined margin.After intravenous administration of contrast agent, the markedly and long-lasted enhancement was seen in all localized cases with hyaline vascular type. While multicentric cases showed different enhancement with correspond with different pathological classification, which 2 cases were markedly enhancement,but 2 cases were mild-moderate enhancemeny. Two of localized lesions were found with punctate, branching calcification, and 3 of localized lesions were found with peripheral scattered enlarged lymph nodes which were pathologically confirmed as reactive lymphadenitis. Conclusions The localized Castleman's disease with predominanthyaline vascular type has characteristics on CT images, including soft tissue mass with markedly and long-lasted enhancement, and some of cases with branching calcification and satellite lesions. However,multicentric Castleman's disease has no obvious features for diagnosis.