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1、T:510080)Te:;(1979-),3,hvDV3,D=,1VYT。YT:u+,E-mail:%?kCTVCh1曾苗雨, 赵振军, 张金娥, 李景雷, 刘艳辉【K1】:探讨淋巴瘤肺浸润的特征性CT表现和病理学特征,以提高对本病的认识。ZE:回顾性分析23例经病理证实的淋巴瘤肺浸润的CT影像资料,并与组织病理学和手术结果比较。T:23例淋巴瘤中霍奇金淋巴瘤5例,非霍奇金淋巴瘤18例。单发病灶7例,多发病灶16例。肺叶肺段型9例,结节肿块型8例,混合型6例。CT病理对比研究显示支气管充气征(14/23, 60.87%)、CT 血管造影征(12/23,52.17%)、磨玻璃结节(3/23,13
2、.04%),跨叶病灶(4/23,17.39%)为较具特征性的征象,对诊断意义较大。:淋巴瘤肺浸润CT 表现具有一定的特征性,对淋巴瘤肺浸润的诊断具有一定的临床价值。【1oM】肺肿瘤;淋巴瘤;体层摄影术,X 线计算机;病理学【ms|】R734.2;R814.42【DSM】A【cI|】1000-0313(2010)09-1007-04Pulmonary involvement of lymphoma:CT features with pathologic correlationZENG Miao-yu,ZHAO Zhen-jun,ZHANGJin-er,et al.Department of Ra
3、diology,Guangdong Genaral Hospital,Guangdong Academy of Medical Sciences,Guangzhou510080,P.R.China【Abstract】Objective:To analyze theCT and pathology features of pulmonary involvement of lymphomaand toim-provetheunderstanding of this disease.Method:TheCT findings of 23 cases with pulmonary involvemen
4、t of lymphomawereretrospectvelyanalyzed and correlated with histopathology.Results:Of the23 cases with pulmonary involvement oflymphoma,therewereHodgkin lymphoma(5cases)andnon-Hodgkinlymphoma(18cases).Multiplelesionswereassessedin 16 cases and singlelesionin7 cases.Theimaging findings wereclassified
5、into 3 types:lobarand segmentalinvolvement(9/23 cases,39.13%),nodularormass-likeinvolvement(8/23 cases,34.78%)and mixed type(6/23cases,26.09%).Airbronchogram(14/23 cases,60.8%),CT angiogram sign(12/23 cases,52.17%),ground glass opacity likenodules(3/23cases,13.04%)andlesion across pulmonary lobes(4/
6、23cases,17.39%)werethecharacteristicfeatures of pulmonaryin-volvementof lymphoma.Conclusions:Relative characteristicCT features of pulmonary involvement of lymphomacould berevealed,which showsclinicalsignificanceinthediagnosisof thedisease.【Key words】Lung neoplasms;Lymphoma;Tomography,X-ray computed
7、;Pathology%?BFhy#&%d%FV93+0f%?。5,%?khn,VCB+。$s23%?kh,iFhmT1,)+CTVC,4hM。ZE1.52003M122009M9,hL%?k23(k,O_11、85_9、m3)。317,o6,M-21 73,(43.8。51UU9,?4(837.539.2),e3,、2,5a。hLi_?#?S_(CEA,CA125,CA153)T(S。2.CTCT648CT(GELightSpeedVCT,GE LightSpeed8,SGE),?9。:F#W1.25 mm,z64 0.625 mm8 1.25mm,j733cm33cm,120kV,4e,8。
8、S1g/F。hd014(1370,ZpSq0K)75ml,320ml,q3.5ml/s。1426s9。3.mshCTm2bD=$sirBin。4Sh1、vl、H、+(h1=k5f)。4.hF_1007bLl2010M9259RadiolPractice,Sep 2010,Vol25,No.9m1肺叶肺段型淋巴瘤肺浸润。a)双肺大片实变,内见支气管充气征(箭);b)镜下见小支气管周围间质内肿瘤细胞浸润,小支气管上皮细胞完整(箭)。病理诊断为非霍奇金淋巴瘤(40,HE)。 m2结节肿块型淋巴瘤肺浸润(单发周围型肿块)。a)右肺上叶单发肿块,边缘光滑,分叶不明显(箭);b)镜下见病灶内弥漫性肿瘤细胞
9、浸润,病变区域未见纤维化改变。病理诊断为非霍奇金淋巴瘤(40,HE)。 m3结节肿块型(单发中央型肿块)淋巴瘤肺浸润。病理诊断为霍奇金淋巴瘤。a)CT增强扫描矢状面重组图(肺窗)示病灶跨叶分布(右肺上叶前段、中叶内侧段);b)纵隔窗示病灶内可见血管造影征(箭)。h|CT_HWWl7?。S10%:%,?FM,HE#M1fF,CD3、CD5、CD20、Ki67、ALK-1。T1.CTVCFh,?h17;?h116。%?kCT+,V|s/3:k=k9(39.13%,9/23)。VC、v9,=s。9?2,?7。9h1,7AU5(m1a),6AU5/;h1(VC(。 v8(34.78%,8/23)。VC
10、F。?5,v2(m2a),kuv3(m3a);?3(m4a)。?h1vl714cm,H;、O,(。3?hCTVCh155s, 2VCk?、v,vl15cm,1VCk?j,vl1 4cm。8h,AU53(m3a),5/4(m3b、4a),t=sh14(m3a)。 6(26.09%,6/23)。HC、v9#F。,AU54(m5a),CT5/2,j2(m5a、5b)。2.hT23,%?5,d%?18。/1VCkW?%(m1b、2b、4b、5c)。)%?k?hq,%?k?hq0.016% 1 ,?hn 2 ,v?;%?#d%?(V?3k,S=3?%?k?3q15%。F%?k5,d%?k18,5hF,VCvM 4 。-,%?ksy5-7 ,S=dBS。D#$s、9Fh,%?kCT1+,3|s3