中国呼吸与危重监护杂志

中国呼吸与危重监护杂志

肺黏膜相关淋巴组织淋巴瘤的 MDCT 表现及临床病理分析

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目的研究肺黏膜相关淋巴组织(MALT)淋巴瘤的多层螺旋 CT(MDCT)表现和临床病理特征。方法回顾性分析 17 例病理确诊的肺 MALT 淋巴瘤患者的临床病理和 MDCT 影像学资料。结果MDCT 表现分 4 型:① 肺炎/实变型;② 肿块/结节型;③ 支气管血管淋巴管型;④ 混合型。影像特征包括空气支气管征 13 例(伴支气管扩张 9 例),肺内多发小结节 11 例,磨玻璃影 9 例,胸腔积液 4 例,肺门及纵隔淋巴结增大 3 例。17 例中 4 例伴有肺外病变。临床症状包括咳嗽、咳痰、气紧、胸痛、发热、盗汗。2 例患者无明显症状。病理表现为大量 B 淋巴细胞浸润,并可见核异质细胞。结论肺 MALT 淋巴瘤的临床表现无特异性,病情进展缓慢,可伴有自身免疫性疾病。其 MDCT 主要表现为肺部实变、结节或肿块影伴支气管充气征,淋巴结肿大少见,确诊需依靠病理。

ObjectiveTo study the clinical and pathological characteristics and imaging manifestations of pulmonary mucosa associated lymphoid tissue (MALT) lymphoma.MethodsThe clinical and multidetector computed tomography (MDCT) imaging data of 17 patients with pathological proven pulmonary MALT lymphoma were reviewed retrospectively.ResultsThe MDCT manifestations were divided into 4 types: ① pneumonia/consolidation, ② mass/nodule type, ③ bronchovascular lymphatic type, ④ mixed type. The imaging features included air bronchiectasis in 13 cases and bronchiectasis in 9 cases. Multiple small pulmonary nodules were found in 11 cases, ground glass opacity in 9 cases, 4 cases of pleural effusion, pulmonary hilar and mediastinal lymph node enlargement in 3 cases. Among these 17 cases, 4 had extra-pulmonary involvement and 2 without obvious symptoms. The main clinical symptoms including cough, expectoration, dyspnea, fever, chest pain, hemoptysis, night sweats. The pathological manifestation is the infiltration of a large number of B lymphocytes and nuclear heterocells.ConclusionsThe clinical manifestations of pulmonary MALT lymphoma are not specific, but the progress is slow, and may be associated with autoimmune diseases. The main MDCT findings of pulmonary MALT lymphoma include consolidation, nodules or masses with air bronchogram. Lymph node enlargement is rare. Clinical diagnosis should also be based on pathological results.

关键词: 肺肿瘤; 淋巴瘤; 肺黏膜相关淋巴组织; 多层螺旋 CT; 病理

Key words: Pulmonary neoplasms; Lymphoma; Pulmonary mucosa associated lymphoid tissue; Multidetector computed tomography; Pathology

引用本文: 张优仪, 杨诚, 蒲红, 李娟. 肺黏膜相关淋巴组织淋巴瘤的 MDCT 表现及临床病理分析. 中国呼吸与危重监护杂志, 2018, 17(5): 488-491. doi: 10.7507/1671-6205.201804004 复制

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