小儿胸腹部恶性淋巴瘤的CT特征

目的　探讨小儿胸腹部恶性淋巴瘤的CT表现 .方法　分析了 33例小儿胸腹部恶性淋巴瘤的CT表现 .结果　胸部 14例 ,其中非霍杰金氏淋巴瘤 (NHL) 10例 ,霍杰金氏病 (HD) 4例 .腹部 19例 ,NHL 15例 ,HD 4例 .CT表现有以下特点 :胸部恶性淋巴瘤多发生在前中纵隔 ,腹部恶性淋巴瘤多发生在腹膜后和肠系膜 ;肿瘤常融合成团 ,边缘多较清楚 ;密度多较均匀与肌肉密度相近 ;未经治疗者未见钙化 ;增强扫描大部分呈轻中度均匀强化 ,少部分不均匀强化和均匀强化并存 ;坏死囊变少见 ;强化后边缘更清楚 ,但未见包膜形成 .小儿NHL与HD有 5个不同点即发病率不同 ;发病年龄不同 ;病灶大小不同 ;发病部位不同和预后不同 .结论　小儿胸腹部恶性淋巴瘤的CT表现有一定的特点 ,CT平扫和增强检查是影像诊断的首选方法

CT Findings of Chest and Abdomal Malignant Lymphoma in Children

Objective To discuss the CT findings of chest and abdomal malignant lymphomas in children. Methods 33 cases with malignant lymphomas in the chest or abdomen were reviewed, 23 males,10 females, mean age was 6.3 years old. All patients were administrated by the CT scanning. Results Of the 14 cases with malignant lymphomas in the chest, 10 cases were Non-Hodgkin's lymphoma(NHL) and the other 4 were Hodgkin's diease(HD). Of the 19 cases which had malignant lymphomas in the abdomen, 15 cases were NHL, 4 cases were HD. CT characteristics were listed: lymphomas in the chest mostly lied in the front and the mid mediastinum; lymphomas in the abdomen often lied in the post-peritoneum and mesentery; the masses were often mixed together and had a clear edge; the density was well-distributed and close to the muscles; no calcify could be seen in non-treated patients; most tumors presented as mildly to moderately well-distributed enhancement after contrast administration. The coexistence of the ill-distributed and the well-distributed enhancement could be seen in the others; necrotic and cystic tumors were rare; The tumor edges became more clearer after contrast administration but no envelope. There are 5 differences between NHL and HD, including accidences, ages, sizes of tumors, positions and prognosis. Conclusions There are some characteristics of the CT findings on chest and abdomal malignant lymphoma in children; CT scan is the first choice of imaging diagnosis.