摘要
目的探讨原发性骨淋巴瘤(primary bone lymphoma,PBL)影像学特征,提高对PBL的认识和诊断水平。方法收集经穿刺或手术病理证实的PBL 12例,回顾性分析其临床表现及X线、计算机断层扫描(computed tomography,CT)和磁共振成像(magnetic resonance imaging,MRI)表现。结果 12例PBL均为非霍奇金淋巴瘤,其中11例为大B细胞淋巴瘤,1例为滤泡性淋巴瘤;9例PBL为单发骨病灶,3例为多发骨病灶。病灶发生于四肢骨5例,脊椎骨4例,其他不规则骨3例。X线和CT表现为溶骨型病灶5例、硬化型3例、混合型3例,1例X线、CT检查结果为阴性;1例仅MRI显示信号异常,另1例术前正电子发射计算机断层显像(positron emission tomography-computed tomography,PET-CT)检查显示局部放射性浓聚。12例PBL均可见病骨周围软组织肿块,以骨质破坏范围小而软组织肿块大为特点,3例伴病理性骨折,4例伴有骨膜反应。12例PBL中术前诊断为骨髓炎、骨髓瘤、骨肉瘤各1例,误诊率25.00%。结论 PBL为少见肿瘤,临床表现缺乏特异性,MRI敏感显示早期病灶,X线、CT与MRI结合能提高PBL诊断准确率。
Objective To explore the imaging features of primary bone lymphoma（PBL）,and improve the understanding and diagnostic ability of PBL.Methods Twelve cases with puncture or surgical pathology proved PBL were retrospectively analyzed by clinical features and imagings of X-rays,computerized tomography（CT）and magnetic resonance imaging（MRI）.Results All 12 PBLs were non-Hodgkins lymphoma,of which 11 were large B-cell lymphoma,1 was follicular lymphoma,9 were single bone lesion,and 3 were multiple bone lesions.Focal lesions were located on limbs in 5 cases,vertebrae in 4 cases,other irregular bones in 3 cases.The X-rays and CT showed osteolytic lesions in 5 cases,sclerosis in 3 cases,mixed-type in 3 cases,negative X-ray and CT result in 1 case.Among them,1 case showed abnormal signal only by MRI,and another case revealed local radioactive concentration by preoperative positron emission tomography computed tomography（PET-CT）.In 12 PBL cases,soft tissue mass around the diseased bone was seen with common features of small bone destruction range and large soft tissue mass.Three cases had pathological fracture and 4 cases had periosteal reaction.One each case of osteomyelitis,myeloma,osteosarcoma were diagnosed preoperatively in 12 PBL cases.The misdiagnosis rate was 25.00%.Conclusion X-ray,CT and MRI can improve the diagnostic accuracy of PBL.PBL is a rare tumor.Clinical manifestations are lack of specificity.MRI sensitive shows early lesions.The combination of X-ray,CT and MRI can improve diagnostic accuracy of PBL.
出处
《华南国防医学杂志》
CAS
2018年第1期26-30,57,共6页
Military Medical Journal of South China
关键词
淋巴瘤
骨肿瘤
磁共振成像
计算机断层扫描
Lymphoma
Bone neoplasms
Magnetic resonance imaging
Computed tomography
