CAJ | 학술논문

目的：探讨皮下脂膜炎样T细胞淋巴瘤（SPTCL）的临床及影像学特征。方法回顾性分析2007年1月至2012年12月经病理确诊的SPTCL共7例，重点分析总结其临床表现、影像学特征。结果（1）临床特点：SPTCL多以皮肤结节就诊（最好发于肢体），常伴发热等全身症状；多累及浅表淋巴结肿大；实验室检查无特殊；最终确诊靠病理。（2）影像特征：X 线片多为阴性，超声检查可作为一般筛查手段，CT、MRI与核医学除可判断病变位置、范围外，还可观察病变的强化程度，髓腔有无受累，并能指导临床穿刺部位。因病变多位于皮下，MRI对肿瘤本身观察最佳，可进一步提供肿瘤细节征象。结论 SPTCL临床无特征性，多种影像学检查可以进一步提供病变部位、范围、发现远处转移、确定穿刺部位及进行疗效评价，最终确诊仍然依靠病理。
목적：탐토피하지막염양T세포림파류（SPTCL）적림상급영상학특정。방법회고성분석2007년1월지2012년12월경병리학진적SPTCL공7례，중점분석총결기림상표현、영상학특정。결과（1）림상특점：SPTCL다이피부결절취진（최호발우지체），상반발열등전신증상；다루급천표림파결종대；실험실검사무특수；최종학진고병리。（2）영상특정：X 선편다위음성，초성검사가작위일반사사수단，CT、MRI여핵의학제가판단병변위치、범위외，환가관찰병변적강화정도，수강유무수루，병능지도림상천자부위。인병변다위우피하，MRI대종류본신관찰최가，가진일보제공종류세절정상。결론 SPTCL림상무특정성，다충영상학검사가이진일보제공병변부위、범위、발현원처전이、학정천자부위급진행료효평개，최종학진잉연의고병리。
Objective To investigate the clinical manifestations and imaging features of subcutaneous panniculitis-like T-cell lymphoma (SPTCL). Methods The clinical manifestations and imaging features of 7 SPTCL patients were retrospectively analyzed from January 2007 to December 2011. Results There were 3 males and 4 females with average age of 37.9 years old (range:24-72). 4 patients presented with multiple subcutaneous nodules or deeply seated plaques, most commonly on the extremities. 3 patients had protracted course of single subcutaneous nodules, with the location of lower limb, chest and shoulder respectively. The common associated symptom was fever (n=4) and lymphadenectasis (n=2). Enlargement of superficial lymph nodes (n=4) were found. Laboratory tests showed a normal liver and renal function test (n=5) and 4 patients had ESR raised. The final diagnosis was based on pathology:high-power view of subcutaneous infiltrate demonstrated small to medium lymphocytes and some large lymphoid cells with irregular nuclei, showing characteristic rimming along adipocytes. Immunohistochemical results showed that heterotypic lymph-like cells in adipose tissue were positive for CD3 (n=6), CD5 (n=4), TIA-1 (n=6), Granzyme B (n=4) while being negative for CD56 (n=7). Imaging features:the plain film (n=7) was negative mostly. Ultrasound (n=4) could be used for screening tool. MRI (n=2), and PET/CT (n=3) could be useful in delineating the extent, finding distant metastasis, confirming the site of puncture, predicting therapeutic effect. Because the lesion was subcutaneous, MRI could supply more details about tumors. Conclusions The clinical manifestations of SPTCL are non-specific. The imaging features are useful in delineating the extent, finding distant metastasis, confirming the site of puncture, predicting therapeutic effect. And the biopsy is necessary for an final diagnosis.