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目的总结肺黏膜相关淋巴组织淋巴瘤的CT及PET-CT表现,提高对该病的认识。方法回顾性分析21例经病理证实的肺黏膜相关淋巴组织淋巴瘤的CT及PET-CT的影像表现。结果所有患者均行CT扫描,其中20例行增强扫描,1例平扫。病灶密度均匀,除1例可见钙化外,其余病变均未见钙化,未见明显低密度区,平扫平均CT值为(47±11)HU,增强后平均CT值为(77±13)HU。发病部位以跨叶分布为主,19例有右中叶或左舌叶病变;CT征象:多发实变15例,多发结节3例,单发肿块2例,单发结节1例(合并结节病,多发小粟粒病灶)。其中病灶内支气管气相征16例,增强后病灶中出现血管造影征16例,病灶紧贴纵隔呈三角型灌注征13例。合并支气管扩张6例,有3例结节合并晕征,小叶间隔增厚9例,肺门及纵隔淋巴结增大9例,CT均显示为直径<1.5 cm小淋巴结;胸腔积液7例,2例胸膜增厚,1例侵犯胸壁。6例行PET-CT检查,均显示病灶明显放射性浓聚,SUV值均>2.5,为3.5~11.7,平均6.7±3.6;4例显示肺门及纵隔淋巴结有放射性浓聚,SUV值为2.7~3.4,平均3.0±0.3。结论肺黏膜相关淋巴组织淋巴瘤部分病灶在CT上有较具特征性的表现,对于诊断有一定提示作用;PETCT对于病灶活性的判断有一定优越性,最终确诊需要病理组织学和免疫组织化学。
Objective To summarize the CT and PET-CT findings of pulmonary mucosa-associated lymphoid tissue lymphoma and to improve their understanding of the disease. Methods The CT and PET-CT images of 21 cases of pathologically confirmed pulmonary mucosa-associated lymphoid tissue lymphoma were retrospectively analyzed. Results All patients underwent CT scan, of which 20 patients underwent enhanced scan and 1 patient underwent plain scan. The lesions were uniform in density. All the lesions were calcified without calcification, and no obvious low density was found. The average CT value of plain scan was (47 ± 11) HU, and the average CT value after enhancement was (77 ± 13) HU . The incidence of the disease mainly in the cross-leaf distribution, 19 cases of right or left lingual leaf lesions; CT signs: multiple consolidation in 15 cases, multiple nodules in 3 cases, solitary mass in 2 cases, single nodules in 1 case (combined knot Arthropathy, multiple small miliary lesions). Among them, there were 16 cases of bronchial gas phase in the lesion, 16 cases of angiography in the lesion after enhancement, and 13 cases of triangular perfusion in the mediastinum. Bronchial dilation in 6 cases, 3 cases of nodules combined halo syndrome, interlobular septal thickening in 9 cases, hilar and mediastinal lymph nodes increased in 9 cases, CT showed small diameter <1.5 cm lymph nodes; pleural effusion in 7 cases, 2 Pleural thickening cases, 1 case of violation of the chest wall. Six cases of PET-CT examination showed significant radioactive accumulation of lesions, SUV values were> 2.5, ranging from 3.5 to 11.7, an average of 6.7 ± 3.6; 4 cases showed hilar and mediastinal lymph node radioactive concentration, SUV value of 2.7 ~ 3.4, an average of 3.0 ± 0.3. Conclusions Some lesions of pulmonary mucosa-associated lymphoid tissue lymphoma have some characteristic features on CT, which may be helpful for diagnosis. PETCT has some superiority in judging the activity of the lesions. The final diagnosis requires histopathology and immunohistochemistry.