南方医科大学学报 ›› 2005, Vol. 25 ›› Issue (10): 1290-1292.

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原发性肝淋巴瘤的临床及影像学诊断

刘方颖1, 陈丹2, 商健彪3, 伍筱梅4, 张雪林1   

  1. 1. 南方医科大学南方医院影像中心, 广东, 广州, 510515;
    2. 中国人民解放军广州疗养院特诊科, 广东, 广州, 510515;
    3. 沈阳军区总医院介入治疗科, 辽宁, 沈阳, 110015;
    4. 广州医学院第一附属医院放射科, 广东, 广州, 510120
  • 出版日期:2005-10-20 发布日期:2005-10-20
  • 基金资助:
    收稿日期:2005-3-25。
    作者简介:刘方颖(1968- ),女,博士,电话:020-61365913,E-mail:shangshuoming@yahoo.com.cn

Clinical and imaging diagnosis of primary hepatic lymphoma

LIU Fang-ying1, CHEN Dan2, SHANG Jian-biao3, WU Xiao-mei4, ZHANG Xue-lin1   

  1. 1. 南方医科大学南方医院影像中心, 广东, 广州, 510515;
    2. 中国人民解放军广州疗养院特诊科, 广东, 广州, 510515;
    3. 沈阳军区总医院介入治疗科, 辽宁, 沈阳, 110015;
    4. 广州医学院第一附属医院放射科, 广东, 广州, 510120
  • Online:2005-10-20 Published:2005-10-20

摘要: 目的 探讨原发性肝淋巴瘤(PHL)的临床及影像学表现特点。方法 回顾性分析4例PHL患者的临床特点及CT、肝动脉造影表现。结果 4例病理组织学检查均为非何杰金氏淋巴瘤,免疫组化结果均为B细胞表型。临床主要表现均有右上腹部疼痛,其中3例有淋巴瘤B症状(发热、盗汗、体质量减轻)。3例合并有慢性肝炎或肝硬化,1例为肾移植术后2年。4例血清乳酸脱氢酶(LDH)水平均明显高于正常,3例手术后LDH降至正常。4例CT平扫肝内病变为边界欠清的低密度影,密度较均匀,增强扫描动脉期、门脉期病灶强化不明显,实质期病灶边界清晰,可见周边或伴分隔状轻度强化。4例肝动脉血管造影均表现为肝内轻度肿瘤染色,供血动脉纤细,肝动脉受压移位明显,未见“抱球征”及明显增粗的肿瘤血管。结论 PHL的临床、CT及血管造影表现缺乏特异性,三者相结合有助于其诊断。血清LDH水平检测可以作为评价疗效的一个重要指标。

Abstract: Objective To investigate the clinical and imaging features of primary hepatic lymphoma (PHL). Methods Four PHL cases were analyzed retrospectively for clinical manifestations, transcatheter hepatic arterial angiography and CT features. Results All the four cases were B-cell non-Hodgkin lymphoma proven by histological and immunohistochemical examination. The main clinical manifestations included pain in the right upper quadrant and B symptoms of the lymphoma (fever, night sweating, and weight loss) in 3 patients. Three cases were complicated by chronic hepatitis or cirrhosis, and the other had renal transplantation two years ago. All these cases exhibited elevated serum lactate dehydrogenase (LDH) level, which was reduced after surgery or chemotherapy. Plain CT scan all identified hypodense lesions which did not display marked enhancement on the arterial phase and portal venous phase scans. On delayed phase scan, the border of the lesions became clear, and slight enhancement was observed in the peripheral and some partitions of the lesions. Angiographic imaging displayed slight tumor staining and arterial displacement in the liver in all the cases with thin tumor-supplying vessels. Global staining or abnormally thickened vessels were not seen. Conclusion A comprehensive evaluation of the clinical manifestations and imaging features can be helpful in the diagnosis of PHL, and serum LDH level may help to assess the therapeutic effect.

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