现代肿瘤医学2009年2月第17卷第2期
原发性脑内恶性淋巴瘤CT、MR表现及其病理学基础梁有禄，陈
琪，赵时棉
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CTandMRlfindingsandcorrespondingpathologicalbasisofprimaryintracerebralmalig nantlymphoma
LIANG You lu,CHEN Qi,ZHAO Shi mei
Department of Radiology,TCM Hospital of Liuzhou City, Liuzhou Guangxi 545001, China.
Objective: To analyze the CT and MRI features and corresponding pathological basis of primary intrac
【Abstract】
erebral malignant lymphoma. Methods : CT and MR findings and pathological data in 12 patients proved by operation and pathology were retrospectively analyzed. Results: The 12 patients presented a single lesion in 5 cases, multiple lesions in 7 cases and 31 lesions altogether. The lesions usually involved the deep white matter of parietal lobe, tem poral lobe and frontal lobe, corpus callosum base ganglia and were round or round like. Most tumors had litle ede ma and mass effect around. On CT scans,the lesions presented as iso or slightly hyper density masses with calcifi-cation and necrosis. On MR scans, the lesions were isointense or slighthy hypointense on T,WI and isointense or slightly hyperontense on T, WI and slightly hyperintense or hyperintsense on DWI. Homogeneous enhancement pres-ented in all of the tumors. In light microscopie,the cells of tumor spread everywhere with the same size, The cells had a little cytoplasm and large nucleus, chromatin granules in which were thick. Tumor cells infiltrated around the vessel, and no calcification, rare hemorrhage or piece of necrosis were seen. All cases were non Hodgkin lymphoma proved by pathology. Conclusion: The corresponding pathological basis of primary intracerebral malignant lymphoma determined which hah contrast enhancement, mass effect and location characteristics on CT and MR imaging. It is possible to make preoperative diagnosis in most cases when imaging findings are combined with clinical infomation.[Key words] brain; malignant lymphoma; magnetice resonance image;tomography;X ray computed
Moderm Oneology 2009,17(02) :0235 0238
目的：分析原发性脑内恶性淋巴瘤的CT、MRI表现及病理学基础，以提高其诊断准确率。方法：回
【摘要】
顾性分析12例经手术病理证实的原发性脑内恶性淋巴瘤的临床病理及其CT、MRI表现。结果：12例患者中有5例单发，7例多发共31个病灶，分别位于额叶、额叶、顶叶深部脑白质、耕体、基底节。病灶多为圆形或类圆形，边界较清楚，瘤周水肿及占位效应轻。CT表现为等或稍高密度实质性肿块，无出血及钙化；MRI表现为T,WI呈略低或等信号、T,WI呈等或稍高信号，DWI多为稍高或高信号，增强后病灶均呈明显均勾强化。病理上肿瘤细胞弥没分布，瘤细胞大小较一致，细胞核大，细胞质少，染色质颗粒粗，可见瘤细胞围绕血管量袖套样浸润，未见明显出血、坏死及钙化，病理结果均为非霍奇金淋巴瘤。结论：原发性脑内恶性淋巴瘤的病理基础决定其CT、MRI的增强形态、占位程度以及肿瘤发生部位具有一定特征，认真分析其影像表现，在多数情况下可以作出术前正确诊断。
【关键词】脑；恶性淋巴瘤；磁共振成像；断层摄影；X线计算机
【中图分类号】R739.91
【文献标识码】A
原发性脑内恶性淋巴瘤是颅内少见肿瘤，约占全部中枢神经系统肿瘤的1%左右[1]，随着免疫抑制剂使用过多及 AIDS病患者的增多，近年来脑内恶性淋巴瘤的发病率有逐渐上升的趋势，免疫功能正常者亦可发病。脑内恶性淋巴瘤影像表现复杂多样，术前定性诊断相对困难，常易误诊，为提
【收稿日期】【修回日期】【作者单位】【作者简介】
2008 04 21 2008 05 28
柳州市中医院放射科，广西柳州545001
梁有禄（1971-），男，壮族，广西柳州人，在职研究生，副主任医师，主要从事神经影像学的研究。
【文章编号】16724992(2009)02023504
高对本病的影像诊断水平，笔者总结12例经手术病理证实的原发性脑内恶性淋巴瘤的影像资料，着重分析其临床病理及CT、MR特征，以探讨原发性脑内恶性淋巴瘤的影像表现
及其病理学基础。材料与方法
收集2003年6月－2007年11月经活检和手术病理证实的12例原发性脑内恶性淋巴瘤患者病例资料，其中男10 例，女2例，年龄34－80岁，平均年龄55岁，临床症状有头痛，恶心、呕吐，视力下降和局灶性神经功能障碍等，全部患者就诊时无免疫状态低下和接受免疫抑制治疗情况，周围血及骨髓穿刺、全身浅表淋巴结检查均未累及，12例全部使用