CAJ | 학술논문

目的探讨头颈部嗜酸性淋巴肉芽肿(KD)的影像表现及病理特征,以提高对该病的术前诊断率.方法回顾性分析8例经病理证实的头颈部KD患者的临床影像及病理表现.结果 8例KD患者中,单发与多发各4例;部位:腮腺6例、口底(颌下腺区)1例、眼睑1例,其中2例累及腹股沟.CT和MRI征象:①累及腮腺者(4例):患侧腮腺、面部弥漫性增大,结节边界欠清或较清,密度略高于腮腺,T1加权像多为等信号,T2加权像信号则多为等、低信号,增强扫描有不同程度强化;②累及头颈部其他部位(如颌下腺区、眼睑等)者:病变密度、信号、强化程度亦与累及腮腺者类似,但可有周围组织的受累(如颅骨);③周围淋巴结常不同程度受累、增大,密度、信号均匀,边界清楚,无坏死,无融合;往往累及局部皮下组织,邻近皮肤增厚.病理:KD组织成分基本一致,均由淋巴细胞、嗜酸性粒细胞、小血管和纤维组织以不同比例组成.结论 KD有一定的好发部位和临床特点,结合影像学检查与病理分析,可大大提高其术前诊断的正确率.
목적 탐토두경부기산성림파육아종(KD)적영상표현급병리특정,이제고대해병적술전진단솔.방법 회고성분석8례경병리증실적두경부KD환자적림상영상급병리표현.결과 8례KD환자중,단발여다발각4례;부위:시선6례、구저(합하선구)1례、안검1례,기중2례루급복고구.CT화MRI정상:①루급시선자(4례):환측시선、면부미만성증대,결절변계흠청혹교청,밀도략고우시선,T1가권상다위등신호,T2가권상신호칙다위등、저신호,증강소묘유불동정도강화;②루급두경부기타부위(여합하선구、안검등)자:병변밀도、신호、강화정도역여루급시선자유사,단가유주위조직적수루(여로골);③주위림파결상불동정도수루、증대,밀도、신호균균,변계청초,무배사,무융합;왕왕루급국부피하조직,린근피부증후.병리:KD조직성분기본일치,균유림파세포、기산성립세포、소혈관화섬유조직이불동비례조성.결론 KD유일정적호발부위화림상특점,결합영상학검사여병리분석,가대대제고기술전진단적정학솔.
Objective To study the pathological and imaging features of eosinophilic hyperplastic lymphogranuloma (Kimura disease, KD) and improve the diagnosis of the KD. Methods The clinical, imaging and pathological features of 8 cases with KD in head and neck region were retrospectively analyzed. Results In 8 cases with KD, 4 cases had solitary nodule and 4 had multiple masses. 6 patients had soft-tissue masses related to parotid glands, whereas other 2 cases were in relation to the submandibular and eyelid separately.CT and MRI findings: ① Extensive swelling of the involved parotid glands and face were depicted in KD patients. Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the KD. The masses were slightly hyper-density on CT scan. They were iso-intensity in T1-weighted sequence and iso- or hypo-intensity in T2-weighted sequence mostly, with different enhancement after administration of contrast medium. ②The masses of KD in other location might involve surrounding structures, such as bone involvement, however they had the similar density, intensity and enhancement pattern with parotid gland. ③All 8 cases had associated lymphadenopathy, which with homogeneous density without necrosis and cyst. Most of their adjacent skin was thicker and subcutaneous fat overlying the subcutaneous masses. Histologic examination demonstrated lymphoid hyperplasia with vascular proliferation and eosinophilic infiltration in the different proportion. Conclusion The position and clinical findings of KD have some characteristic features,with CT, MRI examinations and pathological feature, the accuracy in the diagnosis of KD before operation can be increased.