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1、中国临床医学影像杂志2011年第22卷第10期JChinClinMedImaging,2011,Vol．22,No．10·693·咽淋巴环淋巴瘤的影像学诊断及鉴别陈刚，尹家保，徐峰，张鹏程，党燕威（湖北省襄阳市第一人民医院，湖北襄阳441000）[摘要]目的：探讨咽淋巴环淋巴瘤的CT及MRI表现，以提高诊断及鉴别诊断的准确性。方法：回顾性分析15例经病理证实、临床影像资料完整、原发于咽淋巴环淋巴瘤的CT及MRI表现。结果：病理均为非霍奇金淋巴瘤，B细胞来源10例，NK细胞或T细胞来源占5例。7例腭
2、扁桃体淋巴瘤表现为扁桃体窝内边界清楚的类圆形软组织肿块，向咽腔内突出生长，5例为双侧受累；8例鼻咽及鼻腔淋巴瘤均表现为鼻咽腔内弥漫生长的软组织肿块，病变范围较大，向周围呈弥漫性生长，可累及邻近鼻甲及鼻窦骨质骨无颅底受侵；CT表现为均匀软组织密度肿块与周围界限清楚，MRI上T1WI呈与邻近肌肉组织相似的等密度，T2WI及DWI呈稍高密度，信号均匀，呈轻中度强化，无坏死和囊变；15例淋巴瘤中有10例同时可见双侧颈部淋巴结肿大。结论：咽淋巴环淋巴瘤以非霍奇金淋巴瘤多见，CT、MRI表现其密度、信号、边缘
3、及强化特点有一定特征，需与结核、鼻咽癌及扁桃体癌等鉴别；CT、MRI能清楚显示肿瘤位置、形态、范围及有无颈部淋巴结肿大和周围组织的侵犯，对临床诊断和治疗有重要指导价值。[关键词]淋巴瘤；咽肿瘤；体层摄影术，螺旋计算机；磁共振成像[中图分类号]R733.4；R739.63；R814.42；R445.2[文献标识码]A[文章编号]1008－1062（2011）10－0693－04ImaginganddifferentialdiagnosisoflymphomainWaldeyer’sringCHENG
4、ang,YINJia-bao,XUFeng,ZHANGPeng-cheng,DANGYan-wei(TheFirstPeople’sHospitalofXiangyangCity,XiangyangHubei441000,China)Abstract:Objective:TostudyCTandMRIfeaturesoflymphomainWaldeyer’sring,inordertoimprovetheaccuratediagnosisanddifferentialdiagnosis.Meth
5、ods:TheCTandMRIdataof15casesofnon-Hodgkin’slymphomainWaldeyer’sring,provenpathologicallyandclinicallywerestudiedretrospectively.Results:Pathologyshowedallcaseswerenon-Hodgkin’slymphoma,including10casesfromBcells,and5casesfromNKcellsorTcells.Sevencases
6、ofpalataltonsillymphomashowedroundsofttissuemasswithclearborderinamygdaloidpit,andfivecasesinvolvedbothsides.Eightcasesofpalataltonsillymphomagrewaggressivelywithinnasopharyngealcavity,andsomecaseshadturbinateornasalsinusbonemetastasis.CTimagingshowed
7、clearborderbetweenthemassandpara-tumortissues.ThelymphomaswereisointensetoneighboringmuscleonT1WI,andhyperintenseonT2WIandDWI,andthesignalswerehomogeneouswithmild-to-moderateenhancement,withoutnecrosisandcysticappearances.Tenofthefifteencasesshowedbil
8、ateralswellingofcervicallymphnodes.Conclu-sion:Pharynxlymphaticlooplymphomasweremostlynon-Hodgkin’slymphomas,andtheyhadcharacteristicsofdensity,sig-nalintensity,borders,andenhancementonCTorMRI,whichneeddifferentiationfromtuberculosis,nasophary
