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[目的]探讨原发性乳腺恶性淋巴瘤X线、CT表现,以提高对该病的影像诊断水平。[方法]回顾性分析20例经病理证实的原发性乳腺恶性淋巴瘤的X线、CT表现(12例行X线检查,8例行CT检查)。对肿瘤的部位、大小、形态、边缘、密度及强化形式进行分析。[结果 ]20例患者均为单侧,其中单发17例,双发3例,共23个病灶;肿瘤最大径1.7~10.2cm,18个病灶呈边缘光整、类圆形或椭圆形肿块;5个病灶呈边缘不光整、不规则分叶状肿块,其中2个病灶侵犯乳腺皮肤,1个侵犯皮下脂肪间隙。密度均匀19个,不均匀4个;与正常乳腺腺体相比,X线检查病灶呈稍高密度9个,等密度4个;与正常肌肉相比,CT平扫病灶呈等密度8个,稍低密度2个,所有病灶均未见钙化及毛刺;增强后病灶轻度强化6个,中度强化4个。6例伴腋窝淋巴结肿大,肿大的淋巴结密度均匀,增强扫描呈轻度强化。[结论]边缘光整、密度均匀、轻中度强化、无明显钙化及毛刺的乳腺实质性肿块及伴密度均匀、轻度强化的腋窝肿大淋巴结为原发性乳腺恶性淋巴瘤的影像学特点,X线、CT检查可以准确显示肿瘤累及的范围,有利于临床选取恰当的治疗方案。
[Objective] To investigate the X-ray and CT findings of primary breast malignant lymphoma in order to improve the imaging diagnosis of this disease. [Methods] X-ray and CT findings of 20 cases of primary breast malignant lymphoma confirmed by pathology were retrospectively analyzed (12 cases underwent X-ray examination and 8 cases underwent CT examination). The tumor location, size, shape, edge, density and enhanced form of analysis. [Result] All the 20 patients were unilateral, of which 17 cases were single and 3 cases were double hair. There were 23 lesions in total. The largest diameter of tumor was 1.7 ~ 10.2cm. Eighteen lesions showed edge finishing, round or oval ; 5 lesions were not only the edge of the whole, irregular lobulated mass, of which 2 lesions invade breast skin, 1 violations of subcutaneous fat space. Compared with normal mammary gland, X-ray showed a slightly higher density of 9 lesions and an equal density of 4 lesions. Compared with normal muscles, CT lesions showed equal density of 8 lesions, Slightly lower density of 2, all lesions were no calcification and burr; enhanced lesion enhanced mild 6, moderate enhanced 4. 6 cases with axillary lymph nodes, enlarged lymph node density, enhanced scan showed mild enhancement. [Conclusion] The mammary gland mass with uniform density and mild to moderate enhancement with no obvious calcification and burr and the axillary enlarged lymph node with uniform density and slight density are the imaging features of primary breast malignant lymphoma , X-ray, CT examination can accurately show the extent of tumor involvement, is conducive to clinical selection of the appropriate treatment.