CAJ | 학술논문

目的分析原发性骨淋巴瘤(PLB)及"浮冰征"的影像表现和病理基础.方法回顾性分析经病理证实且临床资料齐全的41例PLB患者的临床与影像特征.41例全部行X线检查,20例行CT检查,12例行MR检查(3例同时行增强扫描).结果 41例PLB中位于扁骨12例,脊柱8例,长骨17例,其他不规则骨4例.发病最多的部位是股骨(10例,24.4%),其次为髂骨(8例,19.5%).长骨病变位于骨干干骺处者11例.41例中无骨膜反应者37例(90.2%).CT显示骨质破坏轻微而出现软组织肿块者12例,伴有明显软组织肿块者9例,出现"浮冰征"者4例.12例MR检查结果中,10例显示软组织肿块,MRI显示病变范围全部大于CT所显示病变范围,其中1例MRI显示大范围骨质异常,但平片及CT显示骨质破坏不明显.结论 (1)骨质破坏轻而软组织肿块明显,或MRI显示骨质异常范围明显超过平片及CT所见,或MRI显示骨质异常而平片及CT显示骨质破坏较轻或未见明显骨质破坏者提示PLB.(2)"浮冰征"是PLB较为特殊的一种征象,其出现对淋巴瘤的诊断具有一定提示意义.
목적 분석원발성골림파류(PLB)급"부빙정"적영상표현화병리기출.방법 회고성분석경병리증실차림상자료제전적41례PLB환자적림상여영상특정.41례전부행X선검사,20례행CT검사,12례행MR검사(3례동시행증강소묘).결과 41례PLB중위우편골12례,척주8례,장골17례,기타불규칙골4례.발병최다적부위시고골(10례,24.4%),기차위가골(8례,19.5%).장골병변위우골간간후처자11례.41례중무골막반응자37례(90.2%).CT현시골질파배경미이출현연조직종괴자12례,반유명현연조직종괴자9례,출현"부빙정"자4례.12례MR검사결과중,10례현시연조직종괴,MRI현시병변범위전부대우CT소현시병변범위,기중1례MRI현시대범위골질이상,단평편급CT현시골질파배불명현.결론 (1)골질파배경이연조직종괴명현,혹MRI현시골질이상범위명현초과평편급CT소견,혹MRI현시골질이상이평편급CT현시골질파배교경혹미견명현골질파배자제시PLB.(2)"부빙정"시PLB교위특수적일충정상,기출현대림파류적진단구유일정제시의의.
Objective To analyze the imaging features of primary lymphoma of the bone,and discuss the special feature of the "floating ice sign". Methods Forty-one cases of primary lymphoma of the bone in our unit from 1963.1-2009.6 were retrospectively studied. All 41 patients underwent X-ray examination, and 20 patients underwent CT examination, 12 patients underwent MR examination (3 cases simultaneously with enhancement).Results Involvement of the flat bone was seen in 12 cases. Vertebral column was affected in 8 cases, and 17 cases showed lesions in long bones and irregular bones were involved in 4 cases. The most common location was the femur(10, 24.4%), followed by the ilium(8, 19.5%). Lesions were found in the metaphyses of the long bone in 11 cases (64.7%). "Floating ice sign" was showed in the calcaneus of 2 patients and in the lumbar vertebra of 2 cases respectively, accounted for 9.8% of all cases. Slight bone destruction with soft tissue mass on CT image could be found in 12 cases, while obvious soft tissue mass was found in 9 cases. No periosteal reaction was found in 37 cases (90.2%). MRI examinations of 12 patients revealed soft tissue mass in 10 patients, and the extent of the lesion was larger in MR than CT. One case showed extensive bone destruction on MR but inconspicuous bone destruction on X-ray plain film and CT scan. Conclusion Slight bone destruction with conspicuous soft tissue mass, conspicuous bone destruction on MR but slight or inconspicuous bone destruction on X-ray film and CT,could strongly imply the diagnosis of primary lymphoma of the bone. "Floating ice sign" was a special imaging feature of primary lymphoma of the bone, which could be used as a clue for the diagnosis of lymphoma.