回盲部原发恶性非霍奇金淋巴瘤CT表现及鉴别诊断

目的探讨CT对回盲部原发恶性非霍奇金淋巴瘤（primary malignant non—Hodgkin—Lymphoma of ileocecum，PMNHLI）的诊断及鉴别诊断的意义。方法回顾性分析2000年12月至2008年7月经CT检查并手术病理证实的PMNHLI 11例CT表现，并分析鉴别诊断的意义。结果CT表现以肠壁浸润性增厚（n=4）和类圆形肿块（n=4）多见，也可表现为多发结节（n=1），因肠套叠而漏诊1例，肿块与肠系膜肿大淋巴结融合1例。区域肠系膜多发淋巴结肿大（n=4）、肠套叠（n=4）、不完全性肠梗阻（n=5）为灶外常见表现。CT诊断正确4例，误诊为结肠癌3例、肠系膜肿瘤、肠腺瘤、脓肿各1例，漏诊1例。结论PMNHLI术前诊断困难，CT表现多样，肠内类圆形肿块为常见表现，如以上征象合并区域肠系膜淋巴结多发肿大则可考虑PMNHLI诊断。

CT diagnosis and differential diagnosis of primary malignant non-Hodgkin-Lymphoma of ileocecum

Objective To evaluate the CT characteristics and differential diagnosis characteristics of primary malignant non- Hodgkin-Lymphoma of ileocecum （PMNHLI）. Methods The CT findings of 1] cases of PMNHLI from DEC-2000 to JUL-2008 were retrospectively analyzed. Results The CT findings included： Diffuse thickness of ileocecal wall （4 cases）, round or oval soft tissue masses （4 cases）, multiple soft tissue nodes （1 case）. Missed-diagnosis because of intussusception in one case, and lesion coalesced with enlarged lymph nodes into masses in one case. The appended findings of the lesions included： multiple enlarged lymph nodes of the regional mesentery （4 cases）, intussusception （4 cases）, and incomplete intestinal obstructions （5 cases）. CT diagnosed correctly in 4 cases, misdiagnosed as colon carcinoma in three cases, as mesenteric tumor, adenoma, abscess in one case respectively, and the other one was miss-diagnosed because of intussusception. Conclusion It＇s difficult to diagnose the PMNHLI pre-operation. CT findings of PMNHLI are variable. Round or oval soft tissue mass is the common sign. Multiple enlarged lymph nodes of the regional mesentery are useful signs.