头颈部结外淋巴瘤的影像诊断

目的:探讨头颈部结外淋巴瘤的CT、MRI表现及临床病理特点。方法:回顾性对照分析51例经外科手术或病理证实的头颈部结外淋巴瘤患者的临床病理及CT、MRI影像资料,评价头颈部结外淋巴瘤的影像及临床病理特点。结果:51例全部为非何杰金淋巴瘤(NHL),其中来源于B细胞32例(62.75%),T细胞19例(37.25%)。原发部位最常见于鼻腔及咽环,其中鼻腔23例(45.10%),咽环(Waldeyer环)20例(39.22%),其余部位共8例(15.69%),包括眼眶3例,喉部、甲状腺各2例,腮腺1例。18例(35.29%)伴淋巴结转移。根据肿瘤形态分为3型,其中单发肿块型31例(60.78%),弥漫肿胀型17例(33.33%),溃疡坏死型3例(5.89%)。结论:头颈部结外淋巴瘤的临床病理及CT、MRI影像表现有一定特征性,影像检查可以显示病变形态、范围及淋巴结转移,结合临床特点对头颈部结外淋巴瘤的诊断、分期及指导治疗有一定价值。

The Imaging and Pathological Analysis of Extranodal Lymphoma in Head and Neck

Objective:To explore the imaging and clinical features of extranodal lymphoma in head and neck. Methods:51 extranodal lymphoma patients in head and neck were confirmed by surgery and pathology.The CT and MR images data were analyzed in comparison with surgical and pathological results.Diagnostic value of the CT and MR imaging were analyzed.Results:All 51 cases were non-Hodgkin lymphoma(NHL).Among all cases B-cell lymphomas accounted for 62.75%(32 cases).19 cases were T-cell lymphoma(37.25%).The most common site of extranodal lymphomas located in nasal cavity and pharynx ring.23 cases in nasal cavity(45.10%), 20 cases in pharynx ring(39.22%),The rest part 8 cases(15.69%),include:3 cases in orbit,2 cases in laryngeal, 2 cases in thyroid and 1 case in parotid.The lymph nodes metastases were observed in 18 cases.According tumor form all lymphoma were divided into three types:31 cases single mass type(60.78%),17 cases diffuse swelling type(33.33%),2 ulcer or necrotic type(5.89%).Conclusion:CT and MR images showed the special characteristics of head and neck extranodal lymphoma.Combined with clinical characteristics the imaging examinations could indicate the location,morphology,surrounding tissue and lymph nodes metastases and have great value in clinical diagnosis,staging and treatment.