摘要
目的探讨头颈部淋巴瘤临床表现、影像学表现及病理特征。方法选取2015年6月至2019年5月间在陕西省森林工业职工医院行头颅CT和增强MRI扫描的62例头颈部淋巴瘤患者为研究对象,分析其影像表现及临床病理特点。结果62例患者中,有56例为非霍奇金淋巴瘤(NHL),均为结外型淋巴瘤;6例为霍奇金淋巴瘤(HL),均为结内型淋巴瘤,其累及部位包括颈部、鼻腔、扁桃体、舌根、甲状腺及喉部等。其中NHL型主要以弥漫性B细胞淋巴瘤和滤过性淋巴瘤为主,HL型以经典型HL为主,并且累及部位以颈部为主。所有患者病理组织活检发现,选取的62例患者中,诊颈部淋巴瘤误诊为淋巴结核4例(13.8%),鼻咽淋巴瘤误诊为鼻咽癌2例(15.4%)。淋巴瘤患者临床症状主要表现为发热、呼吸困难、鼻塞、咽痛和局部肿痛等。CT表现为软组织肿块,CT平扫时为均匀等密度,经增强后逐渐强化。累及部位多表现为淋巴结肿大,且密度均匀,但有部分表现为融合状。且CT表现中,病灶不发生钙化,坏死及囊变现象较少见。NHL型和HL型在T1WI上等信号影有46例(74.2%)、稍高信号影有16例(25.8%);T2WI上稍高信号影2例(3.2%),高信号影60例(96.8%),且可见部分淋巴结融合状;矢状面T2WI(抑脂)均为高信号影,均匀强化。根据影像扫描结果显示,62例患者中增生肿块型有35例(56.5%),软组织肿块、弥漫肿胀有23例(37.1%),颈部软组织弥漫性肿胀、溃疡坏死有2例(3.2%),表现为局部坏死溃烂。结论头颈部淋巴瘤主要以NHL型为主,颈部淋巴瘤的发病率较高,且临床表现较复杂,无明显特征,影像学表现具有一定特征性,但误诊率较高,需结合病理活检确诊。
Objective To investigate the clinical and imaging manifestations and pathological features of head and neck lymphoma.Methods Sixty-two patients with head and neck lymphoma who received head CT and enhanced MRI scans at Shaanxi Provincial Institute of Forestry Staff Hospital from June2015 to May 2019 were selected as research subjects.The clinical and imaging manifestations and pathological characteristics were analyzed.Results Among the 62 patients,56 patients(90.3%)were patients with non-Hodgkin’s lymphoma(NHL),to be specific,extranodal lymphomas.Six patients(9.68%)were patients with Hodgkin lymphoma(HL),to be specific,intranodal lymphomas.The NHL type is mainly diffuse B-cell lymphoma and filter lymphoma,while the HL type is mainly transtypical HL,which involves neck,nasal cavity,tonsils,tongue roots,thyroid gland and larynx,etc.Lymphoma of the neck was misdiagnosed as scrofula in 4 patients(13.8%)and lymphoma of nasopharynx was misdiagnosed as nasopharyngeal cancer in 2 patients(15.4%).The clinical manifestations mainly were fever,dyspnea,nasal obstruction,pharyngeal pain and local swelling and pain.CT scan mainly showed soft tissue lumps of uniform density on plain scan and uniform enhancement on enhanced scan.The clinical manifestations in the involved sites included clustered swollen lymph nodes of uniform density.What’s more,the lesions did not calcify.Necrosis or cystic changes were rare.NHL and HL lymphoma demonstrated equal signal by T1 WI in 46 patients(74.2%)and slightly high-signal shadow in 16 patients(25.8%).NHL and HL lymphoma demonstrated slightly high-signal by T2 WI in 2 patients(3.2%)and high-signal shadow in 60 patients(3.2%),and fusion of lymph nodes were observed in the visible portion.T2 WI was evenly enhanced high-signal shadow in sagittal plane.In addition,35 patients(56.5%)had proliferative lumps,23 patients(37.1%)had diffuse swelling,and 2 patients(3.2%)had ulcer necrosis.Conclusion Non-Hodgkin’s lymphoma(NHL)is the most frequent type of tumors of the head and neck.The incidence
作者
梁红民
崔兆勋
白龙龙
LIANG Hong-min;CUI Zhao-xun;BAI Long-long(Department of Otorhinolaryngology,Shaanxi Provincial Institute of Forestry Staff Hospital,Xi'an 710300,China;Department of Oncology,Shaanxi Provincial Institute of Forestry Staff Hospital,Xi'an 710300,China;Department of CT,Shaanxi Provincial Institute of Forestry Staff Hospital,Xi'an 710300,China)
出处
《中国肿瘤临床与康复》
2020年第1期44-47,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
头颈部淋巴瘤
头颅CT
增强MRI
临床表现
病理特征
Lymphoma of the head and neck
Head CT scan
Enhanced magnetic resonance imaging
Clinical manifestations
Pathological features
