上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

透明血管型Castleman病特征性及罕见CT影像学表现

张静1，林晓珠2，潘自来1,2，陈晓炎3，李卫侠2，汤榕彪2，陈克敏1,2，严福华2   

  1. 上海交通大学 医学院 1.附属瑞金医院北院放射科， 上海 201801； 2.附属瑞金医院放射科， 上海 200025； 3.附属瑞金医院病理科， 上海 200025
  • 出版日期:2015-11-28 发布日期:2016-01-13
  • 作者简介:张静（1982—）， 女， 住院医师， 硕士; 电子信箱: 2qhzhangj@163.com。

Characteristics and rare CT findings of hyaline vascular type Castleman's disease

ZHANG Jing1, LIN Xiao-zhu2, PAN Zi-lai1,2, CHEN Xiao-yan3, LI Wei-xia2, TANG Rong-biao2, CHEN Ke-min1,2, YAN Fu-hua2   

  1. 1.Department of Radiology, Ruijin Hospital North, Shanghai Jiao Tong University School of Medicine, Shanghai201800, China; 2.Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200025, China; 3.Department of Pathology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai200025, China
  • Online:2015-11-28 Published:2016-01-13

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摘要：

目的  探讨和分析透明血管型Castleman病的CT表现，提升诊断准确率。方法  回顾性分析 2010年7月—2015年5月行CT双期增强扫描并经病理证实的透明血管型Castleman病的23例患者资料。结果  23例透明血管型Castleman病中， 21例增强扫描病灶呈显著均匀强化，均分布在大血管旁，且被迂曲粗大血管包绕；1例病灶呈轻度均匀强化，分布在升结肠旁，周围无大血管；另1例骨盆诸骨有成骨性和溶骨性骨质破坏。23例中有4例含钙化灶，其中1例CT表现为中央区星芒状钙化灶，3例边缘分别呈线状、弧线和点状钙化灶。1例病灶位于左颈部，手术切除后1年原手术区复发。结论  透明血管型Castleman病肿瘤位于大血管旁并被粗大迂曲血管包绕者呈显著强化，CT动静脉双期呈持续性显著均匀强化，钙化的特征对透明血管型Castleman 病的诊断具有重要价值。成骨性和溶骨性骨质破坏，局限性透明血管型Castleman 病手术切除后复发属罕见表现。

关键词: 巨淋巴结增生, 透明血管型, CT

Abstract:

Objective  To explore and analyze the CT findings of hyaline vascular type Castleman’s disease and improve the accuracy of diagnosis. Methods  Data of 23 patients who were definitely diagnosed with hyaline vascular type Castleman’s disease by CT dual phase enhanced scan and pathological examination from July 2010 to May 2015 were retrospectively analyzed. Results  Among 23 cases of hyaline vascular type Castleman’s disease, focuses of 21 cases significantly and evenly enhanced, all located along main blood vessels, and were included in curving thick blood vessels. The focus of one case slightly and evenly enhanced, located nearby the ascending colon, and there were on main blood vessels nearby. Pelvic bones of one case showed osteogenetic and osteolytic destruction. Four cases had calcified focuses and the central area of one calcified focus was star shaped and edges of other three calcified focuses were linear, arc, and spotty, respectively. The focus of one case located in left neck and recurred in the same area one year after operation. Conclusion  Tumors of hyaline vascular type Castleman’s disease significantly enhance if they locate nearby main blood vessels and are included in curving thick blood vessels. Continuous, significant and even enhancement and calcification characteristics revealed by CT arteriovenous dual phase are important for diagnosis of hyaline vascular type Castleman's disease. Osteogenetic and osteolytic destruction and recurrence after operation are rare for limited hyaline vascular type Castleman's disease.

Key words: giant lymph node hyperplasia, hyaline vascular type, CT