CAJ | 학술논문

目的探讨肺黏膜相关淋巴组织(MALT)淋巴瘤的CT平扫、增强及HRCT表现,提高对本病的认识.方法收集河南科技大学第一附属医院自2002年5月至2011年10月16例肺MALT淋巴瘤患者资料,均经病理证实,所有病例行CT平扫,7例加增强、9例加高分辨率CT (HRCT)扫描.对16例CT资料进行回顾性分析.结果本组病例的主要CT征象为实变、结节及肿块,其中11例出现2种或以上,5例仅出现1种；同时伴随正常或扩张支气管气像13例,磨玻璃影(GGO)10例,间质性改变及囊腔各5例,部分肺不张及纵隔肺门淋巴结肿大各4例,胸腔积液2例,气管支气管MALT淋巴瘤1例.病变分布特征:12例多发,4例单发；实变、大结节及肿块多沿血管支气管束分布,微小结节呈淋巴管周围性分布,其中8例伴随其他征象出现.增强后气管大结节轻度强化；实变及肿块以明显强化多见,大结节以轻度强化多见,3例可见血管造影征.结论大多数肺MALT淋巴瘤表现为含正常或扩张支气管气像沿血管支气管束分布的实变、大结节及肿块,同时伴随GGO及淋巴管周围性分布的微小结节,特征性的增强表现为明显强化伴血管造影征；少数合并肺间质性改变、囊腔、部分肺不张、纵隔肺门淋巴结肿大、胸腔积液及气管支气管树MALT淋巴瘤.
목적 탐토폐점막상관림파조직(MALT)림파류적CT평소、증강급HRCT표현,제고대본병적인식.방법 수집하남과기대학제일부속의원자2002년5월지2011년10월16례폐MALT림파류환자자료,균경병리증실,소유병례행CT평소,7례가증강、9례가고분변솔CT (HRCT)소묘.대16례CT자료진행회고성분석.결과 본조병례적주요CT정상위실변、결절급종괴,기중11례출현2충혹이상,5례부출현1충；동시반수정상혹확장지기관기상13례,마파리영(GGO)10례,간질성개변급낭강각5례,부분폐불장급종격폐문림파결종대각4례,흉강적액2례,기관지기관MALT림파류1례.병변분포특정:12례다발,4례단발；실변、대결절급종괴다연혈관지기관속분포,미소결절정림파관주위성분포,기중8례반수기타정상출현.증강후기관대결절경도강화；실변급종괴이명현강화다견,대결절이경도강화다견,3례가견혈관조영정.결론 대다수폐MALT림파류표현위함정상혹확장지기관기상연혈관지기관속분포적실변、대결절급종괴,동시반수GGO급림파관주위성분포적미소결절,특정성적증강표현위명현강화반혈관조영정；소수합병폐간질성개변、낭강、부분폐불장、종격폐문림파결종대、흉강적액급기관지기관수MALT림파류.
Objective To explore the imaging findings of non-contrast CT scan,enhancement and HRCT of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma.Methods All the patients with pathologically proven pulmonary MALT lymphoma underwent non-contrast CT scan,of which 7 underwent CT enhancement and 9 had HRCT.CT features of 16 patients were retrospectively reviewed.Results Major CT signs of 16 cases were consolidations,nodules and masses,of which 11 had two or more signs and 5 had only one.Together with them,normal or dilated air bronchograms were seen in 13 cases,ground-glass opacity (GGO) in 10,interstitial changes and cysts in respective 5,partial atelectasis and mediastinal and hilar lymphoadenopathy in respective 4,pleural effusion in 2 and MALT lymphoma of tracheobronchial tree in 1.Multiple lesions were found in 12 cases and solitary lesion in 4 cases.Consolidations,greater tubercles and masses mostly had a peribronchovascular distribution.Micronodules occurred in a perilymphatic distribution,of which 8 accompanied other signs.On CT enhancement scans,greater tubercles in the trachea had mild enhancement; most of the consolidations and masses had obvious enhancement,while greater tubercles mostly mild enhancement.CT angiogram sign was found in 3 cases.Conclusion Most cases with pulmonary MALT lymphoma have consolidations,greater tubercles and masses with normal or dilated air bronchograms which have a peribronchovascular distribution,together with GGO and micronodules in a perilymphatic distribution; the distinctive manifestations are obvious enhancement with CT angiogram sign.Minority cases have interstitial changes,cysts,partial atelectasis,mediastinal and hilar lymphoadenopathy,pleural effusion and MALT lymphoma of tracheobronchial tree.