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目的探讨原发性甲状腺恶性淋巴瘤(PTML)的CT表现特征。方法回顾性分析中国医科大学附属第一医院2000年1月至2011年6月收治的14例PTML病人的CT资料,并对照手术及病理结果。结果 PTML的CT表现共同特征为:平扫肿物密度低于邻近肌肉,质地均匀,增强扫描后无明显强化或轻度强化,仍低于或接近邻近肌肉密度,钙化和坏死少见。CT表现可分为3种类型:本组单发结节型3例,为腺体内单发低密度结节;巨块型8例,肿物巨大,多质地均匀,包膜完整;弥漫渗透型3例,肿物多无明显包膜,向周围组织间隙渗透,增强扫描后于肿物边缘或内部可见狭窄条索状高密度影。结论 PTML的CT表现以巨块型最多见,而弥漫渗透型最具特征性。将CT表现特征与颈部肿物快速增大的病史及甲状腺自身抗体检查相结合有助于PTML的术前诊断。
Objective To investigate the CT features of primary thyroid malignant lymphoma (PTML). Methods The CT data of 14 PTML patients admitted to the First Affiliated Hospital of China Medical University from January 2000 to June 2011 were retrospectively analyzed. The surgical and pathological findings were compared. Results The common features of CT in PTML were as follows: the density of the mass in the mass scan was lower than that in the adjacent muscle, the texture was uniform, no enhancement or slight enhancement was seen after the enhancement scan, and the density of the mass was still lower than or near to the adjacent muscle. CT manifestations can be divided into three types: the group of single nodules in 3 cases, single low-density nodules in the gland; giant block in 8 cases, huge tumor mass, uniform texture, complete capsule; diffuse permeation Type 3 cases, no significant tumor mass coating, the surrounding tissue to penetrate the gap, enhanced scan in the tumor margin or internal visible narrow cord-like high-density shadow. Conclusions The CT findings of PTML are the most common in massive mass, whereas the diffuse osmotic mass is most characteristic. Combining the CT features with a rapidly increasing history of neck mass and thyroid autoantibodies contributes to the preoperative diagnosis of PTML.