摘要
目的:探讨腹部局灶型Castlman病的CT与MR影像特征与病理基础,提高对这种罕见疾病的认识和了解,减少误诊。方法:回顾性分析本院经手术病理证实的10例腹盆腔局灶型Castlman病患者的CT和MR表现及相应临床资料。结果:术后病理2例为浆细胞型,8例为透明血管型。4例位于腹膜后(其中1例位于肾周脂肪裳),4例位于小肠系膜,1例位于大网膜,1例位于右肾下极髓质。4例病灶中央可见树枝状、结节状钙化(包含MR双低信号无强化钙化影),4例较大肿块(直径>5cm)中央出现裂隙及放射状CT低密度区及MR T1WI低信号区,9例病灶周围可见渗出。8例周围可见增粗迂曲血管影。5例周边可见卫星结节子灶。动态增强扫描所有病灶均可见明显强化,其中3例呈渐进性持续强化,7例呈动脉期明显强化,强化程度接近于邻近动脉,延长期强化缓慢消退,4例可见包膜样边缘延迟强化。结论:腹部局灶型Castlman病少见,其影像表现与病理类型密切相关,以透明管型为主。且具有一定影像学特征。腹盆腔孤立性肿块,周边可见卫星结节灶,增粗迂曲管影及不同程度渗出,增强扫描病灶高强化、缓慢消退是腹盆腔局灶型透明血管Castlman的特征表现。较大肿块中心纤维化区域及树枝样钙化出现有助于本病诊断。MR对于显于周边卫星灶及包膜样强化优于CT。
Objective:To explore the CT and MR imaging features and pathological basis of abdominal focal Castlman disease,to improve the knowledge and understanding of this rare disease and reduce misdiagnosis.Methods:The CT and MR findings and corresponding clinical data of 10 patients with abdominal and pelvic focal Castlman disease confirmed by surgery and pathology in our hospital were retrospectively analyzed.Results:Postoperative pathology showed plasma cell type in 2 cases and hyaline vascular type in 8 cases.4 cases were located in the retroperitoneum(1 case was located in the perirenal fat skirt),4 cases were located in the small mesentery,1 case was located in the greater omentum,and 1 case was located in the lower pole medulla of the right kidney.There were dendritic and nodular calcifications in the center of the lesions in 4 cases(including MR double-low signal without enhanced calcification),4 cases of larger masses(>5cm in diameter)showed fissures and radial low-density areas on CT and low-signal areas on MR T1WI in 9 cases.Exudation was seen around the lesions.Thickened and tortuous blood vessels were seen around in 8 cases.Satellite nodules were seen in 5 cases.Significant enhancement was seen in all lesions on dynamic contrast-enhanced scan,among which 3 cases showed gradual and continuous enhancement,7 cases showed obvious enhancement in arterial phase,the degree of enhancement was close to adjacent arteries,and the enhancement gradually faded in extended phase,and 4 cases showed delayed enhancement of envelope-like edge.Conclusion:Abdominal focal Castlman’s disease is rare,and its imaging manifestations are closely related to pathological types,with hyaline casts as the main type,and have certain imaging features.Abdominal and pelvic solitary mass,satellite nodules can be seen around,thickening and tortuous tube shadow.Different degrees of exudation,high enhancement on contrast-enhanced scanning,and slow regression are the characteristic manifestations of focal hyaline vessels in the abdominal and pelv
作者
康正武
方政雄
余育贤
KANG Zheng-wu;FANG Zheng-xiong;YU Yu-xian(Imaging Department,Zhangzhou Hospital,Fujian Province,Fujian Zhangzhou 363000;Department of Radiotherapy,Zhangzhou Hospital,Fujian Province,Fujian Zhangzhou 363000)
出处
《中国医疗器械信息》
2023年第22期11-13,共3页
China Medical Device Information
关键词
巨淋巴结增生
腹盆腔
磁共振成像
MDCT
giant lymph node hyperplasia
abdominopelvic cavity
magnetic resonance imaging
MDCT
