作者单位:300060天津,天津医科大学肿瘤医院放射科/国家肿瘤临床医学研究中心/天津市肿瘤防治重点实验室作者简介:范舒璇(1985-),女,天津人,硕士,住院医师,主要从事CT与MRI诊断工作。·胸部影像学·Castleman病的CT表现及临床病理特点范舒璇,叶兆祥,孟晓燕,马菊香【摘要】目的:探讨Castleman病(CD)患者的临床病理特征、CT表现特点及预后。方法:回顾性分析经手术或活检病理证实并行CT检查的24例CD患者的CT资料和临床资料,并将CT影像表现与病理结果进行对照,分析其CT表现特点。结果:24例中透明血管型15例,浆细胞型8例,混合型1例。15例透明血管型CD临床分型均为单中心型,包括胸部7例、颈部4例、腹膜后2例、盆腔及腹股沟2例,8例浆细胞型CD均为多中心型。透明血管型CDCT表现为边界清楚的软组织密度肿块,内部可见斑点状、分叉状钙化及灶状或条状低密度区;增强后动脉期肿块即明显强化,延迟期仍有强化。3例肿瘤周围见丰富的强化血管影。浆细胞型CDCT表现多发淋巴结肿大,密度均匀,增强后亦明显强化,但较透明血管型强化程度低。透明血管型CD术后均无复发,而浆细胞型CD预后多种多样。结论:CD的CT表现与临床类型、病理分型密切相关。CT对透明血管型CD的诊断具有较高的准确性,尤其是肿瘤内部的钙化及增强CT表现具有重要诊断价值,手术治疗效果好,预后佳;而浆细胞型CD缺乏特征性,确诊需要结合病理学,且预后差。【关键词】巨淋巴结增生;体层摄影术,X线计算机;预后【中图分类号】R733.4;R449;R814.42【文献标识码】A【文章编号】1000-0313(2014)06-0647-04DOI:10.13609/j.cnki.1000-0313.2014.06.017Castlemandisease:computedtomographyandclinicalfindingsFANShu-xuan,YUZhao-xiang,MENGXiao-yan,etal.De-partmentofRadiology,TianjinMedicalUniversityCancerInstituteandHospital,NationalChinicalResearchCenterofCancer,KeyLabortoryofCancerPreventionandTherapy,Tianjin300060,P.R.China【Abstract】Objective:Toanalyzetheclinicopathologicalcharacteristics,CTimagingfeaturesandprognosisofCastle-mandisease.Methods:Twenty-fourpatientswithlymphnodebiopsy-provedorsurgery-provedCastlemandiseasewereret-rospectivelyreviewedinthisstudy.Clinicoradiologicalfindingsofthe24patientswereanalyzed.Results:Of24patients,hya-line-vasculartype(HVT)wasfoundin15patients,plasmacelltype(PCT)in8patients,andmixedtypeinonepatient.The15casesofHVTweresoloitary,whereasthePCTsweremulticentric.In15casesofHVTs,7wereinchest,4inneck,2wereinretroperitonumand2wereingroinandpelvis.HVTshowedwellcircumscribedmasseswithsoft-tissuedensity,punctateorbifurcatecalcificationandlinearlow-densityareasonnon-enhancedC...