胃黏膜相关淋巴组织淋巴瘤CT表现与病理类型之间相关性分析

摘要

Objective:The aim of this study was to describe CT findings of gastric mucosa-associated lymphoid tissue (MALT) lymphoma in 54 patients and to correlate them with histopathologic findings. Methods:We retrospectively collected and reviewed CT examinations of 54 patients from 2008 -2013 with confirmed gastric MALT lymphomas by pathology. Using the histopatho-logicgrade of the MALT lymphomas,we divided the patients into two groups:those with high-grade lymphoma (n=21) and those with low-gradelymphoma (n=33). Common CT findings for the two groups were reviewed and compared. Results:Abnormalities included diffuse or segmental gastricwall thickening (66%,36/54),lymphadenopathy (38%,21/54),ulcer (24%,13/54),and gastric mass (4%,2/54). Fourteen (26%)of 54 patients were found to have no abnormality. Gastric wall thickening in the high-grade group was more diffuse (48% vs. 8%) and severe (71% vs. 14%;severe or moderate) than that seen in the low-grade group. the extent and thickness of the lesions in patients with high-grade histology were significantly wider and thickerthan those in patients with low-grade histology (P<0.001). Gastric ulcer was found in 57% of the high-grade group and in only 5%of the low-grade group ( P<0 . 001 ) . Lymphadenopathy was visualized in 67%of the high-grade group and in 24% of the low-grade group. The gastric mass formation was seenin only two patients in the high-grade group. Conclusion:The common CT findings of gastric MALT lymphoma were gastric wall thickening and lymphadenopathy. Although CTfindings of the two forms of the dis-ease overlap,the visualizationof diffuse gastric wall thickening of severe or moderate degree,mass formation,ulcer,may help one to differentiate high-grade from low-grade gastric MALT lymphomas.%目的：分析54例胃黏膜相关淋巴组织（mucosa-associated lymphoid tissue，MALT）淋巴瘤的CT表现，以及其与病理的相关性。方法：回顾性分析经手术病理证实胃MALT淋巴瘤54例。根据MALT淋巴瘤的病理分级，分为高度恶性淋巴瘤（21例）和低度恶性淋巴瘤（33例），对2组CT结果进行比较。结果：54例中，弥漫性或节段性胃壁增厚36例（66.7%），淋巴结肿大21例（38.9%），溃疡13例（24.1%），胃壁肿块2例（3.7%）。14例（25.9%）无任何异常，均为低度恶性组。高度恶性组在CT上的异常（100%）比低度恶性组异常发生率（51%）高。高度恶性组胃壁增厚程度比低度恶性组高（71%、14%，重度或中度）（P<0.01）。淋巴结肿大高度恶性组占66.7%（14/21），低度恶性组为21.2%（7/33），2组差异有统计学意义（P<0.05）。胃溃疡在高度恶性组中的发生率为57.1%（12/21），在低度恶性组中为3.0%（1/33），2组差异有统计学意义（P<0.001）。胃肿块形成仅在高度恶性组中发现2例。结论：2组胃MALT淋巴瘤的CT表现，均为胃壁增厚，淋巴结肿大，在影像学表现有重叠。胃壁增厚较明显、更弥漫及溃疡提示高度恶性MALT淋巴瘤。