标题：腹部巨淋巴结增生症患者CT影像学特征及诊断价值

      作者：刘涛，杨鹏，刘鹏    延安市人民医院CT诊断科，陕西 延安 716000

      卷次： 2023年34卷23期

      【摘要】 目的 探究腹部巨淋巴结增生症(CD)患者计算机断层扫描(CT)的影像学特征及诊断价值。方法 回顾性分析延安市人民医院经手术或穿刺活检证实为腹部CD的80例患者的CT影像学表现，与病理结果进行对比，分析其表现特征。结果 80例患者中男性12例，女性68例，年龄18~60岁，平均(37.15±3.01)岁；48例(60.00%)肿瘤位于腹膜后腔，16例(20.00%)位于上腹腔内，10例(12.50%)位于肝门与腔静脉之间；6例(7.50%)位于腹盆腔交界区域，平均肿瘤大小为47.5 mm×38.6 mm。本组病例有透明血管型60例，浆细胞型13例，混合型7例；所有患者肿块均边界清晰，形态相对较为规则，其中豌豆形 40例，椭圆形32例，多发小结节型8例，3例显示均匀强化，14例伴有钙化。CT平扫结果显示72例患者表现为单发肿块，主要是局灶肿块型；8例患者表现为多发小结节，主要为多发结节型；57例密度均匀，23例密度不均匀，病灶内可见点状、弧形、分支状或放射状钙化影。结论 腹部巨淋巴结增生症较为少见，以局灶型CD为主，常见为单发强化肿块，肿块边缘光滑，密度均匀，肿块内可见各类型钙化，有一定影像学特征；发现腹部单发强化肿块应考虑该疾病，避免误诊、漏诊。
      【关键词】 巨淋巴结增生症；腹部；体层摄影术；CT影像学特征；病理学；诊断价值
      【中图分类号】 R57 【文献标识码】 A 【文章编号】 1003—6350（2023）23—3455—04

CT imaging characteristics and their diagnostic value in patients with abdominal Castleman's disease.
LIU Tao,YANG Peng, LIU Peng. Department of CT Diagnosis, Yan'an People's Hospital, Yan'an 716000, Shaanxi, CHINA
【Abstract】 Objective To explore the imaging characteristics of computed tomography (CT) and their diagnos-tic value in patients with abdominal Castleman's disease (CD).Methods CT imaging findings of 80 patients with abdom-inal CD confirmed by surgery or biopsy at Yan'an People's Hospital was retrospectively analyzed, and the findings werecompared with pathological results to analyze their characteristics. Results Among the 80 patients, there were 12 malesand 68 females, aged 18-60 years old, with an average age of (37.15±3.01) years. There were 48 cases (60.00%) of tu-mors located in the retroperitoneal cavity, 16 cases (20.00%) located in the upper abdominal cavity, 6 cases (7.50%) lo-cated in the abdominal pelvic junction area, with an average tumor size of 47.5 mm×38.6 mm. There were 60 cases withhyaline vascular type, 13 cases with plasmocyte type, and 7 cases with mixed type. The boundary of all lumps was clear,and their shape was relatively regular. In the 80 patients, there were 40 cases with pea shape, 32 cases with oval shape,and 8 cases with multiple small nodule shape. There were 3 cases with uniform enhancement and 14 cases with calcifi-cation. The results of CT plain scan showed that there were 72 cases with single lump (mainly on focal lump type) and8 cases with multiple small nodules (mainly on multiple nodule type). There were 57 cases with uniform density and23 cases with uneven density. There were punctate, arc-shaped, branched or radial calcification shadows in lesions.Conclusion Abdominal CD is rare, mainly on focal type. It is usually a single enhanced lump with smooth edge anduniform density. There is various types of calcification in lumps, with certain imaging characteristics. CD should be con-sidered when there are abdominal single enhanced lumps, in order to avoid misdiagnosis or missed misdiagnosis.
      【Key words】 Castleman's disease; Abdomen; Tomography; Imaging characteristics of CT; Pathology; Diagnostic value