口腔医学研究

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (7): 651-655.DOI: 10.13701/j.cnki.kqyxyj.2021.07.016

• 口腔肿瘤与口腔影像学研究 • 上一篇    下一篇

腮腺恶性淋巴瘤的螺旋CT影像表现及分析

潘笑1, 胡子洋1, 梁家豪1, 张磊2, 林梓桐1*   

  1. 1.南京大学医学院附属口腔医院,南京市口腔医院口腔颌面医学影像科 江苏 南京 210008;
    2.南京大学医学院附属口腔医院,南京市口腔医院病理科 江苏 南京 210008
  • 收稿日期:2020-12-09 出版日期:2021-07-28 发布日期:2021-07-13
  • 通讯作者: * 林梓桐,E-mail:linzitong710@163.com
  • 作者简介:潘笑(1996~ ),女,黑龙江人,硕士在读,主要从事口腔医学的研究工作。
  • 基金资助:
    江苏省南京市卫生青年人才(编号:QRX17079);南京市卫生科技发展项目(编号:YKK19090)

Manifestation and Analysis of Parotid Malignant Lymphoma with Spiral CT

PAN Xiao1, HU Ziyang1, LIANG Jiahao1, ZHANG Lei2, LIN Zitong1*   

  1. 1. Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China;
    2. Department of Pathology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing 210008, China
  • Received:2020-12-09 Online:2021-07-28 Published:2021-07-13

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摘要： 目的:总结腮腺区恶性淋巴瘤的CT表现,分析不同病理类型的CT影像学特点。方法:收集我院20例腮腺恶性淋巴瘤病例,回顾总结其临床特征,CT表现,组织病理学及免疫组织化学结果。CT表现包括病灶的数目、大小、边界、密度和区域淋巴结受累情况;所有病例进行组织病理学观察,结合免疫组织化学分析进行病理学分型,并通过Ki-67进行肿瘤细胞增殖分析。结果:本研究中20例恶性淋巴瘤均为非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL),其中黏膜相关性淋巴组织淋巴瘤(mucosal associated lymphoid tissue lymphoma,MALT)9例,弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)8例,滤泡性淋巴瘤(Follicular lymphoma,FL)2例,血管免疫母细胞性T细胞淋巴瘤(angioimmunoblastic T-cell lymphoma,AITL)1例。CT图像上,MALT多表现为边界不清晰(7/9);有6例呈沿腮腺轮廓塑形性生长(6/9),密度不均匀8例(8/9);DLBCL:多表现为边界清晰结节影(7/8),可为单发(4/8)或多发(4/8),密度均匀(4/8)或不均匀(4/8)。20例中14例伴有淋巴结肿大。20例患者Ki-67(+)分布于20%~90%,4例DLBCL的Ki-67(+)大于50%。结论:腮腺恶性淋巴瘤多表现为MALT或DLBCL,这两类恶性淋巴瘤在螺旋CT上均具有一定的影像学特点。

关键词: 腮腺恶性淋巴瘤, 弥漫性大B细胞淋巴瘤, 黏膜相关性淋巴组织淋巴瘤, 螺旋CT

Abstract: Objective: To summarize the CT manifestations of malignant lymphoma in parotid region and analyze the CT imaging characteristics of different pathological types. Methods: Twenty cases of parotid malignant lymphoma in our hospital were collected, and the clinical characteristics, CT manifestations, histopathology, and immunohistochemical results were reviewed. CT manifestations included the number, size, boundary, density, and regional lymph node involvement of lesions. Pathological classification was performed combining histopathological observations and immunohistochemistry analysis, and tumor cell proliferation analysis was performed by immunohistochemistry analysis of Ki-67. Results: All 20 cases of malignant lymphoma were non-Hodgkin's lymphoma (NHL), 9 cases were mucosal associated lymphoid tissue lymphoma (MALT), 8 cases were diffuse large B cell lymphoma (DLBCL), 2 cases were follicular lymphoma (FL), 1 case was angioimmunoblastic T-cell lymphoma (AITL). Of 9 MALTs, 7 cases manifested unclear boundaries, 6 cases were plasticized along the parotid contour, and 8 cases manifested uneven density. Of 8 DLBCLs, 7 cases manifested clear boundary, 4 were single nodules and 4 were multiple nodules, 4 presented uniform density, and 4 presented uneven density. 14 of the 20 cases had lymph node involvement. Ki-67(+) was distributed in 20%~90%, and 4 DLBCLs had Ki-67(+) higher than 50%. Conclusion: Most of parotid malignant lymphoma is MALT or DLBCL, both of them have some radiographic manifestations in spiral CT images.

Key words: parotid malignant lymphoma, diffuse large B cell lymphoma, mucosal associated lymphoid tissue lymphoma, spiral computed tomography