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为了明确颈胸交界区淋巴源性肿瘤病变的MDCT影像表现特点、解剖及病理学基础,回顾性收集经病理证实的下颈部和上胸部的淋巴源性肿瘤病变69例(其中淋巴瘤41例,转移瘤28例),分析病变的MDCT表现特点及分布规律,阐明影像学表现与解剖、病理学的相关性。发现淋巴瘤41例中,病灶主要分布于颈外侧浅部21例(51.2%),颈深静脉链区27例(65.9%),锁骨上区31例(75.6%),上纵隔气管旁19例(46.3%),主动脉弓旁23例(56.1%),主肺动脉窗22例(53.7%),前上纵隔17例(41.5%),隆突下11例(26.8%),上纵隔食管旁7例(17.1%);淋巴结转移瘤28例,原发肿瘤为鼻咽癌5例、甲状腺癌7例、肺癌10例和食管癌6例,大多数循淋巴回流方向逐级转移,少部分跳跃式转移,主要分布于颈静脉链周围区23例(82.1%),锁骨上窝区21例(75%),上纵隔气管旁17例(60.7%),前上纵隔18例(64.3%),主动脉弓旁10例(35.7%),肺动脉窗11例(39.2%),上纵隔食管旁8例(28.6%)。因此,颈胸交界区域淋巴源性肿瘤病变可同时累及下颈部和上胸部,其影像学表现及优势解剖分布与其解剖、病理特点密切相关。
In order to clarify the features, anatomy and pathology of MDCT images of lymphoid neoplasms in the junctional area of neck and chest, retrospectively collect 69 cases of pathologically confirmed lesions of lymphoid tumors of the lower and upper thorax (including 41 cases of lymphoma , Metastatic tumor in 28 cases). The characteristics and distribution of MDCT were analyzed, and the correlation between imaging findings and anatomy and pathology was clarified. In 41 cases of lymphomas, the lesions were mainly located in 21 cases (51.2%) in the lateral superficial part of the neck, 27 cases (65.9%) in the deep cervical vein chain region, 31 cases (75.6%) in the supraclavicular region and 19 cases (46.3%), 23 cases (56.1%) aortic arch, 22 cases (53.7%) of the main pulmonary artery window, 17 cases (41.5%) anterior superior mediastinum, 11 cases (26.8% (17.1%). There were 28 cases of lymph node metastases. The primary tumors were 5 cases of nasopharyngeal carcinoma, 7 cases of thyroid carcinoma, 10 cases of lung cancer and 6 cases of esophageal cancer. Most of them were stage by stage lymphatic metastasis and some of them were leapfrog , Mainly in 23 cases (82.1%) around the jugular vein, in 21 cases (75%) in the supraclavicular fossa, in 17 cases (60.7%) in the upper mediastinum, in 18 cases (64.3%) in the anterior superior mediastinum, 10 cases (35.7%), pulmonary artery window in 11 cases (39.2%), the upper mediastinum in 8 cases (28.6%). Therefore, cervical lymph nodes at the junction of regional lymph node lesions involving the lower neck and upper chest, the imaging findings and the advantages of anatomical distribution and its anatomy and pathological features are closely related.