Analysis of Multi-slice CT Images of Pulmonary Mucosa-associated Tissue Lymphoma
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摘要:
目的：探讨肺黏膜相关淋巴组织（MALT）淋巴瘤MSCT影像学特点。方法：回顾性分析2014年2月至2022年7月经病理证实的8例肺MALT淋巴瘤的临床资料及MSCT表现，分析误诊原因。结果：5例行胸部平扫及增强检查，3例仅行胸部平扫，8例患者中单发病灶、多发病灶各4例，表现为大片状高密度影7例，均见支气管充气征，1例表现为混杂密度结片灶；CT增强4例中度强化，1例轻度强化，4例可见血管造影征。结论：肺原发性MALT淋巴瘤是一种低度恶性的惰性肿瘤，MSCT表现具有一定特征性，应及时获取病变组织行病理学检查并结合免疫组化明确诊断。
Abstract:Objective: To explore the mulyi-slice computed tomograpy (MSCT) imaging characteristics of pulmonary mucosa-associated lymphoma tissue. Methods: The clinical data and MSCT findings of eight cases of pulmonary MALT lymphoma confirmed by pathology in our hospital from February 2014 to July 2022 were analyzed retrospectively. The causes of misdiagnosis were also analyzed. Results: Five patients underwent plain and enhanced chest CT scans, and three underwent plain chest CT scans alone. Among the eight patients, four had a single focus, four had multiple foci, and seven showed large patches of high-density shadows. All patients showed air bronchogram, and one showed mixed density patches. CT enhancement showed moderate enhancement in four cases, slight enhancement in one case, and angiography sign in four cases. Conclusion: Primary MALT lymphoma of the lung is an inert tumor with low-grade malignancy. The MSCT findings have certain characteristics. Therefore, it is necessary to obtain diseased tissues in time for pathological examination and immunohistochemistry to make a clear diagnosis.
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Keywords:
- computed X-ray tomography /
- pulmonary tumor /
- lymphoma
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图 1 男性，85岁，双肺多发肺MALT淋巴瘤CT及病理表现
（a）～（c）分别为CT平扫肺窗、纵隔窗及增强动脉期示右肺中叶、左肺上叶及双肺下叶多发大片状高密度影，其内可见“空气支气管征”，直达病灶边缘，部分支气管远段扩张，左侧少量胸腔积液，右侧胸膜增厚，双肺病灶明显强化，可见“血管造影征”。（d）～（f）病检见细胞大小较一致，瘤细胞间可见薄壁的分支小血管，高倍镜下部分肿瘤细胞可呈现浆细胞样分化，肿瘤细胞CD20细胞膜阳性表达。
Figure 1. Male, 85 years old, CT and pathological findings of multiple mucosa-associated lymphoma
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图 2 男性，54岁 右肺下叶肺MALT淋巴瘤CT及病理表现
（a）～（c）分别为CT平扫肺窗、纵隔窗及增强动脉期示右下肺见团片状高密度影，密度不均匀，可见“空气支气管征”，部分病灶内见多发空泡，右侧少量胸腔积液，右侧胸膜增厚，右下肺肿块明显强化，可见“血管造影征”。（d）～（f）病检见淋巴样细胞浸润，细小支气管壁和肺泡上皮破坏，形成淋巴上皮病变，血管管腔及管壁可见少量肿瘤细胞，肿瘤细胞细胞膜Bcl-2阳性表达。
Figure 2. Male, 54 years old, CT and pathological findings of right lower lung mucosa-associated lymphoma
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