摘要
目的 :探讨骨非霍奇金淋巴瘤影像表现及诊断要点。方法 :回顾性分析 2 0例经临床和病理确诊的非霍奇金淋巴瘤病例的X线、CT及MR表现。结果 :骨原发性非霍奇金淋巴瘤 13例 ,继发性 7例 ;B细胞源性 18例 ,T细胞源性 1例 ,组织细胞性 1例。 14例侵犯单骨 ,6例侵犯多骨 ,共侵犯 2 9个骨骼 ,其中骨盆 10例次 ( 10 / 2 9) ,股骨 6例次 ( 6/ 2 9) ,脊柱6例次 ( 6/ 2 9)。X线及CT表现为溶骨型 6例 ,浸润型 4例 ,硬化型 1例 ,混合型 7例 ,囊状膨胀型 2例。 6例MRI检查 4例呈长T1、长T2 信号 ,1例呈中等混杂T1、长T2 信号 ,1例呈等T1、混杂T2 信号 ,增强后均呈斑片状不均匀强化。骨皮质广泛破坏及中断 8例 ,筛孔样破坏 4例 ,皮质完整 8例。全部有软组织肿块 ,14例呈环形 ,包绕病骨生长 ,并超越骨病变的范围 ,3例呈梭形 ,3例呈局限性。 7例有骨膜反应 ,5例合并病理性骨折。结论 :本病最常发生于骨盆、股骨及脊柱 ,多侵犯单骨 ,亦可多骨发病 ,常表现为浸润性、溶骨性及混合性骨破坏。骨破坏范围广泛 ,骨皮质破坏较轻或完整 ,巨大软组织肿块 ,并包绕病骨周围生长是其影像学特点 ,可能与肿瘤细胞产生的细胞因子有关 ,后者可控制广泛的破骨活性。诊断需密切结合临床和病理。
Objective:To discuss X-ray,CT and MR findings of non-Hodgkin lymphoma of bone.Methods:The X-ray,CT and MRI findings of 20 patients with non-Hodgkin lymphoma of bone proved pathologically were retrospectively analysed. Results:13 cases were primary NHL of bone and 7 cases were secondary NHL.There was B-cell origin in 18 cases and T-cell origin in 1 case and histocyte in 1 case.The lesions involved single bone in 14 and multiple bone in 6 (pelvis 10,femur 6 and fertibrae 6).X-ray and CT findings:lesions were osteolytic in 6 cases,infiltrative in 4 cases,sclerotic in 1 case,mixed in 7 cases and cystic-expansive in 2 cases.MRI findings (6 cases):the lesions were hypointense on T 1WI and hyperintense on T 2WI in 4 cases,mixed signal intensity on T 1WI and hyperintense on T 2WI in 1 case,isointense on T 1WI and mixed signal intensity on T 2WI in 1 case.Enhancement in most tumors was heterogenous.The cortical bone was destructed in 12 cases.Soft tissue masses were observed in all cases.Conclusion:NHL of bone usually involves either single bone or multiple bones.The pelvis,femur and vertebrae were the most frepuently involved.Extensive destructions and soft tissue masses are often seen.Diagnosis of NHL should be combined with clinical and pathological findings.
出处
《放射学实践》
2004年第9期671-674,共4页
Radiologic Practice
