原发性肺淋巴瘤的CT诊断

目的:探讨原发性肺淋巴瘤的CT表现,提高诊断水平。方法:1995年8月-2009年9月经病理及免疫组织化学证实的原发性肺淋巴瘤11例患者的CT征象进行分析。结果:CT表现:4例累及双肺,7例累及单肺。征象多种多样。肿块型4例,密度大部均匀密实,其中1例含空气支气管征,普遍缺少毛刺,1例跨叶分布。肺炎实变型3例,其中2例含空气支气管征,1例跨叶,1例磨玻璃影。混杂型4例,片状侵润、粟粒、结节、小肿块、索条状、网结状混合影,以一种病灶为主,两种或多种并存,其中含空气支气管征2例,跨叶分布3例,磨玻璃影2例。其中10例增强检查均为轻至中度强化,3例病灶内可见走形正常的血管影。结论:原发性肺淋巴瘤影像表现多样,以肿块型和肺炎实变型较多见,亦可多种形态病变同时存在,空气支气管征,跨叶分布,磨玻璃影,轻至中度强化,病灶内正常走形血管影,影像与症状及病程不一致,有一定提示性。

CT diagnosis of primary pulmonary lymphoma

Objective：To investigate the CT scanning of primary pulmonary lymphoma（PPL）and to improve the success diagnosis rate of PPL.Methods：The CT scanning of 11 PPL cases from August 1995 to September 2009 were retrospectively analyzed.And all cases were comfirmed by histopathology and immunohistochemistry.Results：The CT scanning showed that out of 11 cases 4 cases had multiple lesions in both lungs,7 cases in one lung.1）Four were mass,including 1 with air-bronchograms,1 with straddling-lobe distribution and all with slight enhancement;2）Three were consolidation including 2 with air bronchogram,1 with straddling-lobe distribution and 3 with slight enhancement;3）Four were combined changes,including 2 with air-bronchograms,3 with stradding-lobe distribution,4 with slight enhancement.Conclusions：The CT image of PPL is various and nonspecific.Pulmonary mass and consolidation with air-bronchograms are common.A few features remain characteristic,such as ground-glass opacity,stradding-lobe distribution,in consolidation with slight enhancement.