CAJ | 학술논문

目的探讨巨淋巴结增生症(CD)患者的CT表现特点.方法回顾性分析经手术或活检病理证实并行CT检查的22例CD患者资料,并将CT影像表现与病理结果进行对照,分析其CT表现特点.结果临床分型局限型18例,包括胸部5例、腹膜后8例、盆腔及腹股沟5例；弥漫型4例.18例局限型CD病理分型均为透明血管型,CT表现为软组织密度肿块,平扫CT值为(45±16)HU,边缘清晰,内部可见斑点状、分叉状钙化及灶状或条状低密度区；增强后动脉期肿块即明显强化,CT值平均升高(56 ±22) HU,延迟期仍有强化,内部低密度灶更明显.强化方式呈均匀强化、渐进式强化和不均匀强化3种.4例肿瘤周围见丰富的强化血管影.4例弥漫型病理分型均为浆细胞型,表现多发淋巴结肿大,密度均匀,增强后亦明显强化,但较透明血管型强化程度低,CT值平均上升(32 ±10)HU.结论局限型CD的CT表现具有一定的特征,尤其是肿瘤内部的钙化及增强CT表现具有重要诊断价值；弥漫型CD的CT表现缺乏特征性.
목적 탐토거림파결증생증(CD)환자적CT표현특점.방법 회고성분석경수술혹활검병리증실병행CT검사적22례CD환자자료,병장CT영상표현여병리결과진행대조,분석기CT표현특점.결과 림상분형국한형18례,포괄흉부5례、복막후8례、분강급복고구5례；미만형4례.18례국한형CD병리분형균위투명혈관형,CT표현위연조직밀도종괴,평소CT치위(45±16)HU,변연청석,내부가견반점상、분차상개화급조상혹조상저밀도구；증강후동맥기종괴즉명현강화,CT치평균승고(56 ±22) HU,연지기잉유강화,내부저밀도조경명현.강화방식정균균강화、점진식강화화불균균강화3충.4례종류주위견봉부적강화혈관영.4례미만형병리분형균위장세포형,표현다발림파결종대,밀도균균,증강후역명현강화,단교투명혈관형강화정도저,CT치평균상승(32 ±10)HU.결론 국한형CD적CT표현구유일정적특정,우기시종류내부적개화급증강CT표현구유중요진단개치；미만형CD적CT표현결핍특정성.
Objective To analyze the CT imaging features of Castleman disease and enhance our knowledge of Castleman disease.Methods Twenty two patients with lymph node biopsy-proved or surgeryproved Castleman disease were retrospectively reviewed in this study.Of the 22 patients,18 had localized lesion and 4 patients had multicentric lesions.Correlation was made between CT and pathologic findings.Results Eighteen patients with localized Castleman disease had the hyaline-vascular type and showed well-circumscribed masses with soft-tissue density [mean CT value,(45 ± 16) HU],punctate or bifurcate calcification and linear low-density areas on non-enhanced CT images.All localized masses showed significant enhancementwith an increase of(56 ± 22)HU on arterial phase and showed residual enhancement and some low-density areas on delayed phase.Enhancing patterns were variable,including homogeneous enhancement,gradual enhancement from the edge to the center of mass and heterogeneous enhancement.Four patients with localized lesion demonstrated enhancing vessels around masses.Four patients with muhicentric CD belonged to the plasma cell type and had multiple enlarged lymph nodes.Plasma cell type masses with homogeneous density also showed enhancement after injection of contrast media but appeared to reveal a less increase of (32 ± 10) HU than the hyaline vascular type.Conclusions The localized Castleman disease showed certain characteristics on CT imaging includingcalcification and contrast enhancing patterns,which could help in the differential diagnosis of this disease.The muhicentric Castleman disease did not reveal any useful imaging features.