原发性脑淋巴瘤的CT、MRI表现与病理对照研究_临床医学论文.docVIP

原发性脑淋巴瘤的CT、MRI表现与病理对照研究_临床医学论文 原发性脑淋巴瘤的CT、MRI表现与病理对照研究_临床医学论文 作者：金志发，龙晚生，罗学毛，左克扬，胡茂清，黄秀芳 【摘要】 　　目的 探讨原发性脑淋巴瘤(PLB)的CT、MRI表现特征及病理基础。方法 收集经手术、病理和免疫组化证实，资料齐全的PLB 17例，分析其CT、MRI及病理表现。结果 17例患者中单发11例，多发6例，共25个病灶，分布于脑深部中线附近病灶19个（76.00%），分布于灰白质交界区及脑表面病灶6个（24.00%）。肿瘤形态多为类圆形肿块或结节，瘤周水肿多为轻至中度水肿。CT平扫多呈等密度或略高密度影。T1WI呈等、低信号，T2WI呈等、高信号，增强后呈明显均匀增强。B细胞来源的14例，多为LCA、CD20、CD79阳性；T细胞来源的3例，多为LCA、CD45RO、CD3阳性。结论 PLB的病理学基础决定其CT及MRI表现特征，结合临床及影像学表现特征可以对该病作出正确诊断。 【关键词】 淋巴瘤 计算机体层摄影 磁共振成像 病理学 临床 Abstract: Objective To summarize the CT and MRI features of primary lymphoma of brain (PLB) as well as its pathogenesis. Methods 17 cases of PLB proven by operative findings, pathological and immuohistochemistry examination were collected. Their CT, MRI findings and the pathological conditions were retrospectively analyzed. Results Of 17 cases, the foci were single in 11 cases and multiple in 6 cases. There were 25 foci in total. 19 foci (76.00%) located in proximal deep brain of middle line, 6 foci (24.00%) in albocinereous junction and the surface of brain. Tumors presented node or mass, most foci showed mild or moderate edema. On CT scanning, the foci mostly appeared as isodensity or slightly high density. On MRI, the foci presented iso-or hypo-intense on T1WI while on T2WI it presented iso-or mildly hyper-intense relative to grey matter, the foci were homogeneously and markedly enhanced after contrast injection. 14 cases of PLB derives from B type cell, the LCA, CD20, CD79 were positive.3 cases of PLB derives from T type cell, the LCA, CD45RO, CD3 were positive. Conclusions PLB have some CT and MRI features, which are determined by their corresponding pathologic characteristics. Correct diagnosis can be made in most cases when imaging findings are combined with clinical conditions. 　　Key words: lymphoma; computed tomography;magnetic resonance imaging; pathology, clinical 　　原发性脑淋巴瘤(primary lymphoma of the brain, PLB)是指原发于颅脑、体内其它部位均无发生的淋巴瘤。一般认为中枢神经系统原发性淋巴瘤仍是较为少见的颅内肿瘤［1］，临床容易误诊。CT、MRI检查是诊断PLB并指导临床治疗、