摘要
目的:总结儿童腹部伯基特淋巴瘤(Burkitt’s lymphoma,BL)的临床及CT特征并分析CT误诊原因,提高儿童腹部BL的诊断水平。方法:回顾性收集经病理证实的71例儿童腹部BL的临床及42例治疗前CT资料。分析71例儿童腹部BL的临床特征、42例治疗前CT特征及误诊原因。结果:71例BL中,男60例,女11例,平均年龄(6.8±0.1)岁,早期24例(Ⅰ+Ⅱ期,33.8%),晚期47例(Ⅲ+Ⅳ期,66.2%),总体缓解63例(88.7%),死亡8例(12.3%)。42例治疗前行全腹部CT平扫及增强扫描。儿童腹部BL累及胃肠道31例(73.8%),合并周围器官浸润20例(47.6%)。治疗前CT诊断符合率为81%。根据CT误诊原因,把儿童腹部BL分为胃肠型、结型和混合型。其中胃肠型14例(33.3%),表现为肠(胃)壁弥漫性增厚。结型15例(35.7%),以软组织肿块为主,肠壁增厚不显著。混合型13例(31.0%),同时出现肠壁弥漫性增厚及淋巴结肿大,且泌尿系统浸润较胃肠型及结型更常见(P=0.024)。结论:儿童腹部BL常累及胃肠道,以肠(胃)壁弥漫性增厚及/或合并软组织肿块为特征,易合并周围组织浸润。胃肠型容易误诊为间质瘤,结型容易误诊为恶性肿瘤,混合型具有典型影像学表现,绝大部分可以准确诊断。
Objective:To summarize the clinical and CT characteristics of abdominal Burkitt's lymphoma(BL)in children,analyze the causes of misdiagnosis,and improve the diagnostic accuracy of abdominal BL in children.Methods:A retrospective analysis focused on 42 children with pre-therapy CT data and 71 with clinical data of abdominal BL.The clinical characteristics of 71 cases of abdominal BL in children were studied,as well as the CT characteristics of 42 cases and as well as the causes of misdiagnosis.Results:Of the 71 children with abdominal BL,60 were males and 11 were females,with an average age of 6.8±0.1 years.Among them,24 cases were in the early stage(Ⅰ+Ⅱ,33.8%)and 47 cases were in the late stage(Ⅲ+Ⅳ,66.2%).Sixty-three cases(88.7%)showed overall remission,and 8 cases(12.3%)died.Before therapy,42 cases underwent plain and enhanced abdomen CT scans.A total of 31 cases(73.8%)had gastrointestinal tract involvement,while 20 cases(47.6%)had peripheral organ invasion.The accuracy rate of CT diagnosis before treatment was 81%.Children's abdominal BL was divided into three types according to the cause of the CT misdiagnosis:gastrointestinal type,nodular type,and hybrid type.Fourteen cases of gastrointestinal type(33.3%)displayed diffuse thickening of the intestinal(gastric)wall.Fifteen cases of nodule type(35.7%)displayed soft tissue masses with no significant intestinal wall thickening.Thirteen cases of hybrid type(31.0%)displayed diffuse thickening of the intestinal wall and lymph node enlargement,and urinary system infiltration was more common than gastrointestinal and nodule type(P=0.024).Conclusion:Abdominal BL in children often involves the gastrointestinal tract and is characterized by diffuse thickening of the intestinal(gastric)wall and soft tissue masses,which are prone to peripheral tissue infiltration.The gastrointestinal type is easily misdiagnosed as a stromal tumor,the nodular type is easily misdiagnosed as a malignant tumor,and the hybrid type has typical imaging manifestations,most of which can be accurately diagnosed.
作者
朱敏
黄雯静
鹿连伟
蔡培珊
吴慧莹
ZHU Min;HUANG Wen-jing;LU Lian-wei;CAI Pei-shan;WU Hui-ying(Department of Radiology,Guangzhou Women and Children's Medical Center,Guangzhou Medical University,Guangzhou 510623,China)
出处
《中国临床医学影像杂志》
CAS
CSCD
北大核心
2024年第12期851-855,共5页
Journal of China Clinic Medical Imaging
关键词
伯基特淋巴瘤
腹部肿瘤
儿童
误诊
体层摄影术
X线计算机
Burkitt Lymphoma
Abdominal Neoplasms
Child
Diagnostic Errors
Tomography,X-ray Computed
