CAJ | 학술논문

目的探讨磁共振检查对脾脏原发性淋巴瘤(PSL)的诊断价值.方法经手术病理证实的脾脏PSL患者3例,均采用磁共振检查,分析其影像学表现及诊断情况.结果 3例手术后病理诊断均为B细胞型非霍奇金淋巴瘤,磁共振检查表现为多发肿块型2例,巨块型1例;磁共振平扫表现为脾脏不规则增大,呈等/稍长T1稍短T2信号巨大肿块影像,脾周围见线样长T1、长T2信号,脾门血管被包绕;增强扫描后,脾脏病变不均匀强化,呈等、低混杂信号,腹膜后病变呈中等均匀强化.免疫组化提示弥漫大B细胞型2例,肿瘤细胞CD20及CD19α弥漫(+)、CD3、CD5散在(+)、CD43(+)、CD45RO(+)、CD10(+/-)、Mum(+)、MAC387散在(+),B系淋巴浆细胞型1例,CD79α(+)、CD23(+)、CD38(+)、λ(+).结论 PSL的磁共振表现具有特征性,有助于明确诊断,确诊依靠手术病理和免疫组化检查.
목적 탐토자공진검사대비장원발성림파류(PSL)적진단개치.방법 경수술병리증실적비장PSL환자3례,균채용자공진검사,분석기영상학표현급진단정황.결과 3례수술후병리진단균위B세포형비곽기금림파류,자공진검사표현위다발종괴형2례,거괴형1례;자공진평소표현위비장불규칙증대,정등/초장T1초단T2신호거대종괴영상,비주위견선양장T1、장T2신호,비문혈관피포요;증강소묘후,비장병변불균균강화,정등、저혼잡신호,복막후병변정중등균균강화.면역조화제시미만대B세포형2례,종류세포CD20급CD19α미만(+)、CD3、CD5산재(+)、CD43(+)、CD45RO(+)、CD10(+/-)、Mum(+)、MAC387산재(+),B계림파장세포형1례,CD79α(+)、CD23(+)、CD38(+)、λ(+).결론 PSL적자공진표현구유특정성,유조우명학진단,학진의고수술병리화면역조화검사.
Objective To evaluate the value of MR in the diagnosis of primary splenic lymphoma (PSL).Methods The MR imaging features of 3 PSL cases proved by pathology were retrospectively reviewed. Results Three cases were all pathologically diagnosed as B-cell non-Hodgkin's lymphoma(NHL). Two cases were multiple node shape and one was massive shape. Unenhanced MR imaging revealed heterogeneous splenic enlargement, with large nodules showing iso-hyperinternse on T1WI and hypointense on T2WI. Linear hyperintense on T1WI and T2WI was seen on the spleen peripherous. The spleen vascular was infiltrated. CE-MRI showed heterogeneous enhancement of spleen with iso-hypointense. The focus of postperitoneal showed medial enhancement. Immunohistochemistry-showed 2 cases of diffuse B cell. The CD20 and CD19 α of tumor cell showed diffuse( + ) ,CD3 ,CD5 individual( + ) ,CD43 ( + ) ,CD45RO( + ), CD10 ( +/- ), Mum ( + ), MAC387 individual ( + ), 1 case of B lymphocell type, CD79α ( + ) ,CD23( + ) ,CD38( + ) ,λ( + ). Conclusion The MR imaging features of PSL were characteristic and helpful in the diagnosis of PSL, but the correct diagnosis was still dependent on the pathology and immunohistochemical staining.