原发性甲状腺淋巴瘤的CT表现及其病理相关性

摘要

Objective To investigate the correlation between CT findings and pathological results of primary thyroid lymphomas so as to improve the accuracy of diagnosis. Methods CT findings of 13 patients with primary thyroid lympho-mas were retrospectively reviewed. All the cases were diagnosed as B cell non-Hodgldns lymphomas. The location, size, sharp, density, enhancement and relationship with surrounding structure were evaluated on CT image. Results Diffuse large B-cell lymphoma were shown 3 patients had a diffuse goiter in both of the thyroid lobes and 2 patients had a diffuse goiter in only one of the thyroid lobes while 2 patients presented with a solitary nodule > 4 patients with homogeneous density while 3 patients with inhomogeneous density. 6 patients with irregular uniformity while 1 patient with regular uniformity, all 7 patients shwoed low or light enhancement, 4 patients were revealed metastatic lympadenopathy on the neck and 1 patient infiltrated the adjacent structures. Mucosa-associated lymphoma tissue were shown 1 patient had a diffuse goiter while 3 patients presented with a solitary nodule, 2 patients with irregular uniformity and 2 patient with regular uniformity, all 4 patients with homogeneous density, a light enhancement, and without the adjacent structures infiltrated. Mucosa-associated lymphoma tissue with large cell transformation model: both patients had a diffuse goiter in only one or both of he thyroid lobes, irregular uniformity, light enhancement, 1 patent had homogeneous density while the other inhomogeneous density, only 1 patient revealed metastatic lympadenopathy on the neck. Conclusion CT can reflect the pathological features of primary thyroid lymphomas by demonstrating their corresponding imaging features.%目的 探讨原发甲状腺淋巴瘤CT表现与其病理的相关性,以提高术前确诊率.方法 回顾性分析13例经病理证实的B细胞来源的非霍奇金甲状腺淋巴瘤CT图像进行观察,对其病变的位置分布、形态、边缘、密度、强化及周围侵犯的情况进行统计并探讨与其病理类型的相关性.结果 弥漫性大B细胞淋巴瘤表现为:双侧叶弥漫性肿大3例、单侧叶弥漫性肿大型2例、局灶结节型2例；密度均匀减低4例、不均匀减低3例；界不清6例、界清1例；7例均强化不明显或轻微强化；颈部淋巴结受累4例、累及颈部周围软组织1例.粘膜相关淋巴组织B细胞淋巴瘤表现为:甲状腺弥漫肿大1例、局灶结节3例；界清与界不清各2例；4例密度均匀、强化不明显且均未见颈部淋巴结或周围软组织受侵.粘膜相关淋巴组织B细胞淋巴瘤大细胞转化型表现为:双侧叶、单侧叶各1例均呈弥漫性肿大,界不清；密度均匀减低1例、不均匀减低1例；1例颈部淋巴结受累,2例强化均不明显,未累及周围软组织.结论 甲状腺淋巴瘤的CT表现常表现为甲状腺弥漫性肿大、界清、平扫呈稍低密度、强化不明显、颈部淋巴结受累等,不同病理类型的甲状腺淋巴瘤CT表现有一定差异.