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1.
OBJECTIVE: Nasal T-cell/natural killer cell lymphoma is a new clinicopathologic entity with a characteristic immunophenotypic profile and distinct clinical features. This study describes the radiologic features of nine cases of proven nasal T-cell/natural killer cell lymphoma. CONCLUSION: Nasal T-cell/natural killer cell lymphoma is often a locally destructive (T stages 3 and 4) disease, typically presenting with obliteration of the nasal passages and maxillary sinuses. Involvement of the adjacent alveolar bone, hard palate, orbits, and nasopharynx is found in more than 50% of cases and is associated with extensive soft-tissue masses. Presence of bone erosion is suggestive but not diagnostic of the disease.  相似文献   

2.
鼻腔T/NK细胞型淋巴瘤的影像学诊断   总被引:6,自引:0,他引:6  
目的探讨鼻腔T/NK细胞型淋巴瘤的CT和MRI特点。方法回顾性分析35例经组织学证实鼻腔T/NK细胞型淋巴瘤的影像学资料。结果根据病变的范围分为局限型和弥漫型2种类型。CT表现:局限型25例,位于鼻腔前部23例,后部2例,向前浸润鼻前庭、鼻翼、鼻背及邻近面颊部皮肤23例;病灶密度均匀8例,不均匀17例,增强后低度强化6例,中度强化3例;中下鼻甲、鼻中隔轻微浸润性破坏2例。弥漫型10例,表现为鼻腔中线区骨质破坏伴软组织肿块,9例侵犯邻近鼻窦及面颊部软组织,6例蔓延到眼眶、颞下窝、翼腭窝,4例浸润颅底骨髓,3例破坏硬腭。MRI表现:T1WI低信号5例(与肌肉比较,以下同),等信号3例;T2WI高信号6例,等信号2例;病变低度强化2例,中度强化4例。3例沿翼腭窝神经周围蔓延。结论大多数鼻腔T/NK细胞型淋巴瘤有特征影像学征象,可提示诊断。  相似文献   

3.
Two cases of natural killer (NK)/T-cell primary nasal lymphoma with similar clinical presentations are reported, for comparison and contrast, to highlight the clinical issues and challenges posed by this unusual disease, its aggressiveness being matched only by its rarity. Presenting as a lesion in the nasal cavity with histological features of malignant lymphoma, primary nasal lymphoma is an uncommon extranodal lymphoma, which poses problems in both diagnosis and management. In people of oriental descent, the common cell subtype is NK/T-cell. Although it is generally thought that combination treatment with chemotherapy and radiation is the best management for early stage non-Hodgkin's lymphoma (NHL), there is still debate as to whether combined therapy is optimal treatment for this particular subtype of NHL, given that it responds less well to conventional chemotherapy. Herein we report two patients to illustrate these controversies.  相似文献   

4.
目的:分析和总结鼻腔原发NK/T细胞淋巴瘤的CT和MRI表现,探讨其影像学特征,以提高诊断的准确性.方法:回顾性分析25例经病理证实的鼻腔原发NK/T细胞淋巴瘤的CT和MRI影像资料.结果:原发肿瘤位于单侧鼻腔10例,双侧鼻腔8例,发生在鼻后孔7例.肿瘤侵犯周围结构包括鼻旁窦受累11例,鼻咽12例,鼻唇沟9例,口咽11...  相似文献   

5.
目的探讨鼻腔NK/T细胞淋巴瘤的CT及MRI表现特征。材料和方法回顾性分析21例经病理证实的鼻腔NK/T细胞淋巴瘤患者的CT和MRI影像学资料及临床资料。结果本组21例中单侧7例,双侧14例,依据病变范围将本病分为局限型和弥漫型两种类型。局限型13例,主要位于鼻腔内,其中鼻腔前部11例,鼻腔后部2例;骨质改变不明显,浸润鼻旁或面部皮下组织9例,弥漫型8例,肿瘤范围广泛并向鼻腔周围结构浸润扩展,其中累及鼻旁窦7例,侵入眼眶1例、颞下窝2例,延伸至鼻咽、口咽部并累及咽旁间隙6例,骨质破坏7例,颈部淋巴结受累1例。CT显示肿瘤呈软组织密度充填鼻腔并沿鼻黏膜蔓延,增强后轻到中度不均匀强化。MRIT1WI肿瘤呈等信号,信号强度类似或稍低于肌肉;T2WI呈不均匀稍高信号,信号强度高于肌肉,但低于鼻黏膜,增强后轻到中度不均匀强化。结论鼻腔NK/T细胞型淋巴瘤影像学表现有一定特征,CT、MRI检查可提示诊断,有利于确定病变范围及临床分期。  相似文献   

6.
目的 分析鼻NK/T细胞淋巴瘤的CT表现.方法 回顾性分析11例鼻NK/T细胞淋巴瘤、134例鼻息肉、24例鼻内翻乳头状瘤的CT征象,将相应征象在3类疾病中出现的差异用Fisher精确检验比较.结果 较鼻息肉,鼻NK/T细胞淋巴瘤多单侧鼻腔发病,表现为结节肿块或铸型生长,易侵犯鼻前庭、鼻翼及鼻背部皮肤、鼻咽侧壁、鼻中隔或鼻底部黏膜、周围骨质破坏;较鼻内翻乳头状瘤,鼻NK/T细胞淋巴瘤病变易侵犯鼻前庭、鼻翼及鼻背部皮肤、后鼻孔及鼻咽腔、鼻中隔或鼻底部黏膜.结论 鼻NK/T细胞淋巴瘤多发生于单侧鼻腔,密度均匀,沿侧壁匍匐生长,易侵及鼻黏膜及前后组织结构,早期骨质破坏轻微.  相似文献   

7.
目的探讨鼻腔NK/T细胞淋巴瘤的表现特征。方法回顾性分析26例经病理证实的鼻腔NK/T细胞淋巴瘤患者的CT表现,评价其诊断意义。结果 CT表现:①21例发生于鼻腔前部;②15例出现鼻背部及面颊部软组织肿胀,皮下脂肪消失;③8例出现骨质破坏,其中7例破坏较轻微;④6例出现咽淋巴环增厚;⑤5例增强扫描表现为轻度强化。结论鼻腔NK/T细胞淋巴瘤具有相对特异性的CT表现,咽淋巴环增厚具有一定诊断价值,CT检查对本病诊断具有重要意义。  相似文献   

8.
PURPOSE: To analyze the influence of radiotherapy doses, chemotherapy doses, and clinical parameters on in-field disease control to assess the optimal radiation doses for treatment of non-Hodgkin's lymphoma according to the newly proposed WHO classification. PATIENTS AND METHODS: Subjects consisted of 35 extranodal marginal-zone B-cell lymphomas of mucosa-associated lymphoid tissue (MALT) type, 75 diffuse large B-cell lymphomas (DLBCL), 14 follicular lymphomas, 17 extranodal natural killer (NK)/T-cell lymphomas, nasal type, eight unclassified peripheral T-cell lymphomas, four anaplastic large-cell lymphomas, T/null cell type, and five others. 59 patients received radiotherapy alone. 98 patients received CHOP, modified CHOP, or more intensive chemotherapy, and six patients were treated with other combination. RESULTS: No patients with MALT lymphoma had in-field local recurrence. There were no recurrences in DLBCL patients who received chemotherapy in which the doses of adriamycin were > 200 mg/m(2), nor in DLBCL patients who were treated with > 45 Gy. Only nine of 15 patients with T-cell lymphoma treated with < or = 50 Gy and three of five patients treated with > 50 Gy had local control. The dose of adriamycin had no influence on local control of T-cell lymphoma. CONCLUSION: T/NK-cell lymphomas were more radioresistant than B-cell lymphomas. The prognosis for peripheral T/NK-cell lymphomas is poor even when treated by irradiation combined with chemotherapy.  相似文献   

9.
The aim of this study is to describe the imaging features of neck nodes in non-Hodgkin's lymphoma (NHL). The MR scans of 61 patients undergoing staging of a primary extranodal NHL of the head and neck were reviewed retrospectively. Those MR images with nodal disease were assessed for (a) the pattern of nodal disease, (b) presence of nodal necrosis and (c) presence of extracapsular neoplastic spread (ENS) and nodal matting. The features of the nodal disease were analysed in relationship to the sites of the primary NHL (palatine tonsil (PT) n=23, nasal cavity (NC) n=24, nasopharynx (NP) n=6, other extralymphatic sites (OES) n=8), and histology (natural killer/T-cell (NK/T) n=26, diffuse large cell (DLC) n=24, other subtypes (OS) n=11). Nodal disease was present in 26 patients (43%) and occurred in NHL of the PT n=16 (70%), NP n=3 (50%), NC n=5 (21%) and OES n=2 (25%) and in DLC n=15 (63%), NK/T n=6 (23%) and OS n=5 (45%). Nodal disease was significantly more frequent in DLC than NK/T lymphomas (p=0.0053). Nodal disease spread in a contiguous fashion in 25 (96%) patients with nodes. Necrosis was present in 7 of 26 (27%) being present in DLC of the PT in 5, NK/T of the NP in one and NK/T of the NC in one. ENS and matting were present in 19 (73%) and 13 (50%) patients with nodes, respectively. ENS was found in DLC, NK/T, OS, NC, NP, PT, OES (11, 4, 4,1, 2, 14, 2, respectively) and matting was found in DLC, NK/T, OS, NC, NP, PT, OES (9, 3, 1, 0, 2, 10, 1, respectively). Nodal NHL spreads in a contiguous fashion and is most commonly associated with DLC lymphoma of the NP and PT in Waldeyer's ring. Extracapsular nodal spread is frequent and found in most histological subtypes especially those arising from Waldeyer's ring. Necrosis is more common than previously believed.  相似文献   

10.
目的 探讨鼻咽非霍奇金淋巴瘤(NHL)的MRI表现特征及鉴别诊断.方法 回顾性分析41例经病理证实的鼻咽NHL的MRI表现.评价病灶的大小、分布、侵犯范围及淋巴结累及情况.对B细胞型和T或NK/T细胞型2组NHL的侵犯生长方式比较采用Fisher确切概率法或Pearson卡方检验.结果 41例患者中,成熟B淋巴细胞肿瘤26例,成熟T淋巴细胞肿瘤2例,NK/T细胞瘤13例.病灶以鼻咽黏膜增厚或形成软组织肿块为主要表现,在T2WI上呈稍高信号,T1WI呈等信号,增强后均匀轻到中度强化.均匀累及鼻咽各壁24例,伴溃疡形成5例,超腔生长9例,累及舌或腭扁桃体共23例,邻近肌肉受侵20例,颅底骨质破坏12例.41例患者中,25例合并咽后淋巴结受侵,27例合并颈部淋巴结受侵.NK/T淋巴细胞型鼻咽NHL更易超腔生长、咽旁结构侵犯、溃疡形成(T或NK/T淋巴细胞型鼻咽NHL分别为8、11、4例,B淋巴细胞型鼻咽NHL分别为4、10、1例),B淋巴细胞型鼻咽NHL扁桃体侵犯更常见(B淋巴细胞型鼻咽NHL为18例,NK/T淋巴细胞型鼻咽NHL为5例).结论 鼻咽NHL在MRI上表现具有一些特点,鼻咽各壁均匀增厚多见,常累及鼻腔或扁桃体,当肿瘤体积较大但没有或仅有少许深度侵犯时要考虑NHL.不同病理类型鼻咽NHL其MRI表现有一定差异.
Abstract:
Objective To characterize the features of Nasopharyngeal non-Hodgkin's lymphoma (NHL) on MR imaging and find the main points to differentiate it from the other nasopharyngeal tumors.Methods The MR images of 41 patients with pathologically and immunohistochemically proven nasopharyngeal NHLs were reviewed retrospectively. Images were assessed by the size, invasive extent,signal intensity of primary nasopharyngeal tumor, and the distribution of cervical lymphadenopethy. The difference of regional tissues invasion and cervical lymphadenopathy distribution between the patients with B-cell NHLs and the patients with T-cell or NK/T-cell NHLs were analyzed by Pearson's Chi-Square test or Fisher's exact test Results Of the 41 patients, 26 patients had mature B-cell lymphoma, two patients with mature T-cell Iymphoma, and thirteen patients showed Nature killer/T-cell lymphoma in nasopharynx. MRI revealed that NHLs of nasopharynx can be showed as thickening of nasopharyngeal mucosa and (or) lumps in nasopharynx, which were slightly hyper-intensity on T2-weighted images, and intermediate signal intensity (similar to muscle) on T1 -weighted images, with mild or moderated enhancement following contrast medium administration. Twenty four cases had symmetrical disease of all walls of nasopharynx, and 17 cases had unsymmetrical tumor. Of all cases, 5 cases had superficial ulcerations, 9 cases had exceed nasoharynx invasion spreads superficially along the mucosa, 23 cases had invasion of lingual and (or) palatine tonsils,20 cases showed invasion of parapharygeal muscles, 12 cases suffered from skull base bone infiltration,25 cases had retropaharyngeal lymphadenopathy, and 27 cases had cervical lymhadenopathy. Patient with nasopharyngeal Nature killer/T-cell lymphoma had a higher incidence of exceed nasopharynx invasion,parapharyngeal structures invasion, and superficial ulcerations (the cases were 8, 11, 4 in patient with T-cell or N K/T-cell lymphoma, and 4, 10, 1 in patients with B-cell lymphoma, respectively). Patients with nasopharyngeal B-cell lymphoma had a higher incidence of inasion of lingual and (or) palatine tonsils.Conclusions Nasopharyngeal NHL is a homogeneous tumor that tends to diffusely involve all walls of the nasopharynx and spread in an exophytic fashion to fill the airway, rather than infiltrating into the deep tissues. Different pathological types of nasopharyngeal NHLs have some different appearance on MRI between each other. A large tumor in nasopharynx that fills the nasopharynx cavity, with no or minimal invasion into deep structures, but with invasion extend down into the lingual and(or)palatine tonsils, may suggest the diagnosis of nasopharyneal NHL.  相似文献   

11.
鼻腔鼻窦淋巴瘤的CT和MRI诊断   总被引:8,自引:1,他引:7  
目的 探讨鼻腔鼻窦淋巴瘤的CT和MRI表现,旨在提高其诊断准确性。资料与方法 回顾性分析46例经手术或活检证实的鼻腔鼻窦淋巴瘤患者的影像资料。结果 原发于鼻腔30例,鼻窦7例,鼻腔、鼻窦同时发病或累及邻近结构9例。CT表现:淋巴瘤位于鼻腔前部28例,后部2例,向前浸润鼻前庭、鼻翼、鼻背及邻近面部皮肤22例;病灶密度均匀8例,不均匀22例,增强后轻度强化7例,中度强化6例,鼻中隔、中下鼻甲浸润性破坏7例。鼻窦淋巴瘤表现为窦腔内充以软组织影,窦壁骨质浸润性改变5例,明显破坏2例,4例上颌窦周软组织浸润,增强后中度强化3例。弥漫型淋巴瘤表现为鼻腔中线区不同程度的骨质破坏,鼻腔及邻近鼻窦伴软组织肿块,6例并累及邻近面部软组织、眼眶、鼻咽部、口咽、颞下窝、翼腭窝,4例浸润颅底骨髓,2例破坏硬腭。MRI表现:T1WI低信号12例(与肌肉比较。以下同)。等信号8例;T2WI高信号11例,等信号9例;病变轻度强化6例,中度强化10例。4例沿翼腭窝神经周扩散。结论 多数鼻腔淋巴瘤及弥漫型鼻腔鼻窦淋巴瘤有特异影像学征象,可提示诊断;鼻窦淋巴瘤则缺乏特异影像学征象。CT是本病诊断的主要影像检查方法,MRI能更清楚显示病变的范围。帮助临床准确地分期。  相似文献   

12.
OBJECTIVE: To describe the radiologic findings of primary peripheral T-cell lymphoma (PTCL) of the face other than mycosis fungoides. METHODS: Computed tomography (CT) and magnetic resonance imaging (MRI) findings of 5 consecutive patients with pathologically proven primary facial PTCL other than mycosis fungoides were retrospectively evaluated. Patients with PTCL involving the sinonasal cavity or lymph nodes were excluded. RESULTS: Diagnoses of patients included in this study consisted of natural killer/T-cell lymphoma (n = 2), subcutaneous panniculitis-like T-cell lymphoma (n = 1), anaplastic large cell lymphoma (n = 1), and PTCL not otherwise specified (n = 1). Infiltration or swelling of the superficial space of the face was noted on both CT and MRI, mimicking inflammation or infection. Also seen were well-enhancing small nodular (n = 2) or infiltrative mass-like lesions (n = 2) within the areas of infiltration, which showed intermediate signal intensity on T2-weighted images. One patient demonstrated infiltration and swelling alone. CONCLUSIONS: Primary facial PTCL is a rarely encountered tumor and demonstrates infiltration or swelling mimicking inflammation or infection. Nodular or infiltrative mass-like lesions may be helpful for its diagnosis.  相似文献   

13.
目的:探讨鼻腔鼻窦恶性淋巴瘤的CT特点。材料和方法:回顾分析14例经病理证实鼻腔鼻窦淋巴瘤的CT表现。结果:鼻腔病灶12例,9例起源于鼻腔前部或鼻前庭,鼻窦腔病灶2例;病灶肿块表现4例,浸润表现3例,混合表现7例,多数(11/14)密度相对均匀;位于鼻窦腔者骨质破坏明显,2例均可见骨质缺损;位于鼻腔者骨质破坏不明显或较轻微,5例可见骨质吸收;病灶易累及邻近结构,6例鼻翼、鼻背部皮肤肿胀,皮下脂肪层消失,3例颊部软组织肿胀。结论:鼻腔鼻窦恶性淋巴瘤CT表现有一定特征性。  相似文献   

14.
目的探讨^18F-脱氧葡萄糖(FDG)PET/CT在自然杀伤(NK)/T细胞淋巴瘤的病灶检测及分期中的价值。方法13例初诊和2例复发NK/T细胞淋巴瘤患者行全身^18F-FDGPET/CT显像。病灶处出现^18F-FDG异常浓聚为阳性。^18F-FDG摄取采用最大标准摄取值(SUVmax)进行定量。所有受检者随访时间均〉6个月。统计学比较用t检验。结果(1)15例NK/T细胞淋巴瘤患者^18F-FDG PET/CT显像均为阳性。11例鼻型患者中,10例PET/CT于鼻腔或鼻咽部探测到肿瘤病灶,且6例突出鼻腔外侵及鼻旁周围组织,7例PET/CT显像于鼻腔外发现1处或多处淋巴瘤受侵病灶。4例非鼻型患者,PET/CT于鼻腔外发现多部位肿瘤侵犯。鼻内、鼻外病灶的SUVmax分别为12.42±9.25和9.54±7.12,两者差异无统计学意义(t=1.120,P〉0.05)。(2)15例中有2例显像前不明原因发热者在PET/CT引导下行病理检查,明确诊断。13例诊断已明确者,7例PET/CT发现更多淋巴瘤病灶,6例因PET/CT检查改变分期。Ⅰ~Ⅱ期患者的SUVmax;稍低于Ⅲ~Ⅳ期者,分别为8.44±5.56和10.32±7.80,但差异无统计学意义(t=0.757,P〉0.05)。结论NK/T细胞淋巴瘤病灶呈^18F-FDG高摄取;在其病灶检测和分期方面,PET/CT显像有优势。  相似文献   

15.
鼻息肉的CT表现与诊断价值   总被引:2,自引:0,他引:2  
目的:总结分析鼻息肉的CT表现特点,评价CT扫描对鼻息肉的诊断价值。方法:97例均行轴位及冠状位扫描,其中轴位24例,冠状位73例,全部病例经鼻内窥镜手术及病理证实。结果:97例中双侧发病72例,单侧发病25例。鼻息肉主要发生在筛窦及中鼻道,部分累及上颌窦及下鼻道,在CT断面上表现为鼻腔内息肉样肿块,均合并不同程度的鼻窦炎,冠状位CT扫描比轴位显示清楚。结论:鼻息肉在CT断面上有比较特征性的表现,诊断明确,冠状位能提供与功能鼻内窥镜手术方位一致的解剖层面,能清楚显示鼻道解剖结构和病变特点,对指导纤维内窥镜手术进路及防止并发症有重要指导意义。  相似文献   

16.
A 49-year-old man presented with a left nasal cavity mass, biopsy of which revealed extranodal NK/T cell lymphoma. A PET-CT scan showed increased F-18 FDG uptake in the nasal mass, anterior mediastinal lymph nodes, and multiple subcutaneous nodular deposits in the chest wall, gluteal region, and right femoral areas. The patient achieved complete remission with salvage l-asparaginase therapy after failing first-line standard anthracycline-based chemotherapy. PET-CT was very useful in detecting subcutaneous nodules consistent with widespread dissemination. There is limited literature data on the use of the PET scan in the diagnosis and staging of extranodal nasal NK/T-cell lymphomas. Our case highlights the important role of F-18 FDG PET in the staging of these patients.  相似文献   

17.
Annals of Nuclear Medicine - Natural killer T-cell lymphoma (NKTCL) is an aggressive type of non-Hodgkin’s lymphoma. While FDG-PET/CT imaging has been increasingly utilized for disease...  相似文献   

18.
ObjectivesTo summarize the distinct imaging features of different subtypes of primary nasopharyngeal non-Hodgkin's lymphomas (NHLs).Materials and methodsClinical data and magnetic resonance imaging findings of 71 patients with histologically proven primary nasopharyngeal NHLs were retrospectively reviewed. The tumor distribution, signal intensity, lesion texture, contrast enhancement properties, extra-chamber involvement, regional structure invasion, and cervical lymphadenopathy were evaluated and compared between different subtypes of NHLs.ResultsOf the patients, 70.4% had B-cell lymphomas; 64.8% had symmetrical and diffuse involvement of nasopharynx walls; and 19.7% had superficial ulcerations. Extra-chamber involvement and regional structure invasion occurred in most patients. The frequency of neck node involvement was up to 83.10%; 62.7% of them were bilateral involvement. Patients with T-cell or nature killer/T-cell NHLs had a higher incidence of superficial ulcerations, nasal cavity, and paranasal sinus invasion than B-cell NHLs (P< .05). Patients with B-cell NHLs had a higher incidence of cervical lymphadenopathy specifically in Level VA and parotid region than T-cell or nature killer/T-cell (NK/T-cell) NHLs (P< .05).ConclusionPrimary nasopharyngeal NHLs had some characteristic imaging features and different subtypes of nasopharyngeal NHLs had some distinct imaging features.  相似文献   

19.
BACKGROUND AND PURPOSE: Solitary extramedullary plasmacytoma (SEP) is rare. The purpose of this study was to determine the CT and MR imaging features of SEP of the nasal tract. METHODS: We retrospectively reviewed three CT and two MR images of three histologically proved cases in two men and one woman aged 43-66 years. RESULTS: The plasmacytomas predominantly involved the nasopharynx in two cases and the nasal cavity in one. Two of the tumors were bulky solid masses, whereas the third showed infiltrative features. They were predominantly masses or infiltrative lesions with soft-tissue attenuation on CT scans. The lesions were isointense and hyperintense on T1- and T2-weighted MR images, respectively. The tumors revealed moderate-to-marked contrast enhancement and may have been associated with lytic bone destruction. CONCLUSION: The imaging features of SEP are nonspecific. However, this entity should be included in the differential diagnosis of tumors in the nasopharynx and nasal cavity.  相似文献   

20.
Epstein-Barr virus (EBV) prevails among more than 90% of the adult population worldwide. Most primary infections occur during young childhood and cause no or only nonspecific symptoms; then the virus becomes latent and resides in lymphocytes in the peripheral blood. Inactive latent EBV usually causes no serious consequences, but once it becomes active it can cause a wide spectrum of malignancies: epithelial tumors such as nasopharyngeal and gastric carcinomas; mesenchymal tumors such as follicular dendritic cell tumor/sarcoma; and lymphoid malignancies such as Burkitt lymphoma, lymphomatoid granulomatosis, pyothorax-associated lymphoma, immunodeficiency-associated lymphoproliferative disorders, extranodal natural killer (NK) cell/T-cell lymphoma, and Hodgkin’s lymphoma. The purpose of this article is to describe the spectrum of EBV-related diseases and their key imaging findings. EBV-related lymphoproliferative disorders and lymphomas are especially common in immunocompromised patients. Awareness of their clinical settings and imaging spectrum contributes to early detection and early treatment of possibly life-threatening disorders.  相似文献   

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