摘要
目的 通过CT扫描分析中国人非霍奇金淋巴瘤 (NHL)侵犯腹部和盆腔淋巴结的分布规律及其与西方人的差异。方法 NHL经腹部和 (或 )盆腔CT发现淋巴结阳性者 2 4 1例 ,96例符合入组条件 ,其中 (1)初诊未治患者 :腹部和 (或 )盆腔CT扫描发现有淋巴结病变 ,共 74例 ;(2 )经治复发患者 :既往腹部和 (或 )盆腔CT正常 ,现腹部和 (或 )盆腔淋巴结病变为新出现者 ,共 14例 ;(3)经治患者 :病变缓解停止全身性治疗 (化疗 )已 6个月以上 ,既往未做CT扫描 ,现腹部和 (或 )盆腔CT扫描发现淋巴结受累 ,共 8例。按照临床归类标准分为惰性淋巴瘤 31例 ,侵袭性淋巴瘤 6 1例 ,高度侵袭性淋巴瘤 2例 ,不能归类 2例。CT扫描腹部 4 7例 (包括至腹主动脉分叉 ) ,盆腔 3例 ,腹部和盆腔 4 6例。有80例行增强扫描。淋巴结分布按照腹膜后、肠系膜、腹腔、膈脚后、横膈、髂总、髂内、髂外、腹股沟组分区。结果 淋巴结分布以腹膜后最常见 (74 89) ,惰性与侵袭性淋巴瘤相似 ,分别占 83.3% (2 5 30 )和 83.1% (49 5 9)。其中腹膜后肾门上下区均受侵最多 ,惰性和侵袭性淋巴瘤分别为 72 .0 % (18 2 5 )和6 7.3% (33 4 9) ;盆腔 (41.9% ,12 6 30 1)次之 ,分别为 5 7.5 % (5 0 87)和 35 .5 % (83.1% ,76 2 14 )。肠系膜淋巴结 (37.1% ,
Objective To study the distribution of abdominal and pelvic lymph nodes involved in non-Hodgkin lymphoma in Chinese patients. Methods CT images of 241 non-Hodgkin lymphoma patients with abdominal and pelvic lymph nodes involved were reviewed. Of them, 96 patients whose clinical and image data fulfilled the requirements of the analysis were included: 1. Positive abdominal and/or pelvic nodular lesion in untreated patients examined by CT (n=74). 2. New lesions in abdominal or pelvic lymph nodes who never had any nodular lesion by previous abdominal and/or pelvic CT (n=14). 3. Treated patients who did not have abdominal and/or pelvic CT before, showed regression of initial disease for at lease 6 months after chemothrapy and patients showing abdominal and/or pelvic nodal lesions (n=8) were assessed. In accordance with Clinical Schema for the Lymphoid System, these patients were divided into 3 histology subtypes: indolent (IL; n=31), aggressive (AL; n=61) and very aggressive (VAL; n=2) lymphoma. The remaining 2 cases were unclassified (UCL). Both abdominal and pelvic CT scans were undertaken in 46 patients, abdominal CT only in 47 patients and pelvic CT only in 3 patients. Enhanced CT with iv contrast was obtained in 80 patients. The anatomic sites involved were designated as retroperitoneal (i.e. paraaortic), mesenteric, abdominal (i.e. celiac, paracardiac, gastrohepatic, and hepatic hilar, etc), retrocrural, subdiaphragmatic, common iliac, internal iliac, external iliac, and inguinal nodes, respectively. Results The lesions were located in the retroperitoneum, with an incidence of 83% for both IL and AL. These were predominantly seen superior and inferior to the renal hila, with incidences of 72.0% (18/25) in IL and 67.3% (33/49) in AL. Pelvic lymph nodes came the next, with incidences of 41.9% (126/301 sites of IL and AL), 57.5%(50/87 sites)in IL and 35.5% (76/214 sites)in AL. Mesenteric lymph nodes stood third with incidences of 37.1% (33/89 IL and AL), 43.3% (13/30) in IL and 33.9% (20/59) in AL. There was only one statistically significant evidence that the external iliac lymph nodes were much more commonly seen in IL than in AL (P<0.05). Conclusion In Chinese patients, retroperitoneal, iliac, and mesenteric nodes are the most commonly involved lymph nodes in NHL. The involved retroperitoneal lymph nodes are predominatly located superior and inferior to the renal hila. The anatomic distribution of abdominal and pelvic lymph nodes in NHL of Chinese patients is different from that of the western countries.
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2002年第6期580-584,共5页
Chinese Journal of Oncology
