李紅英

【摘要】 目的：探討睪丸非霍奇金淋巴瘤MRI表現(xiàn)與病理特征。方法：回顧性分析本院2015年3月-2019年2月經(jīng)手術(shù)病理確診的睪丸非霍奇金淋巴瘤患者35例的臨床資料。所有患者均行病理檢查與3.0T MRI平掃，其中30例行MRI增強(qiáng)掃描。分析睪丸非霍奇金淋巴瘤MRI表現(xiàn)與病理特征及兩者關(guān)系。結(jié)果：35例患者M(jìn)RI診斷符合率為85.71%（30/35），5例誤診為睪丸精原細(xì)胞瘤。睪丸非霍奇金淋巴瘤MRI表現(xiàn)為T1WI與T2WI呈均勻略低信號(hào)，DWI呈均勻高信號(hào)。30例行MRI增強(qiáng)掃描，其中27例有輕度均勻強(qiáng)化，3例因壞死呈不均勻輕度強(qiáng)化。病例診斷結(jié)果為35例患者中彌漫大B細(xì)胞淋巴瘤32例，NK/T細(xì)胞淋巴瘤3例。腫瘤細(xì)胞彌漫浸潤于睪丸實(shí)質(zhì)內(nèi)，使曲細(xì)精管破壞，其間部分纖維形成，間質(zhì)內(nèi)無豐富的毛細(xì)血管網(wǎng)，與MRI信號(hào)較均勻、增強(qiáng)掃描僅呈現(xiàn)輕度強(qiáng)化基本一致。3例有灶性壞死，與病灶MRI信號(hào)欠均勻表現(xiàn)一致。結(jié)論：T1WI與T2WI呈均勻略低信號(hào)，DWI呈均勻高信號(hào)為睪丸非霍奇金淋巴瘤MRI特征性表現(xiàn)。曲細(xì)精管破壞、其間部分纖維形成、間質(zhì)內(nèi)無豐富的毛細(xì)血管網(wǎng)的病理特征與MRI增強(qiáng)掃描僅呈現(xiàn)輕度強(qiáng)化一致。典型MRI表現(xiàn)可為睪丸非霍奇金淋巴瘤診斷提供依據(jù)。

【關(guān)鍵詞】 睪丸 非霍奇金淋巴瘤 MRI

[Abstract] Objective： To explore the MRI manifestations and pathological features of testicular non-Hodgkins lymphoma. Method： The clinical data of 35 patients with testicular non-Hodgkins lymphoma diagnosed by surgery and pathology in our hospital from March 2015 to February 2019 were retrospectively analyzed. All patients underwent pathological examination and 3.0T MRI plain scan， of which 30 cases underwent MRI enhanced scan. The MRI manifestations and pathological features of testicular non-Hodgkins lymphoma and the relationship between them were analyzed. Result： The coincidence rate of MRI in 35 cases was 85.71% （30/35）， and 5 cases were misdiagnosed as testicular seminoma. The MRI manifestations of testicular non-Hodgkins lymphoma showed slightly uniform low signal on T1WI and T2WI， and uniform high signal on DWI. 30 patients underwent enhanced MRI， among which 27 cases showed mild uniform enhancement， and 3 cases showed uneven mild enhancement due to necrosis. The results of pathological diagnosis were 32 cases of diffuse large B cell lymphoma and 3 cases of NK/T cell lymphoma among 35 patients. The tumor cells infiltrated into the testicular parenchyma and damaged the seminiferous tubules. Some fibers were formed in the seminiferous tubules. There was no abundant capillary network in the stroma， which was basically consistent with the MRI signal uniformity and the enhancement scanning only showed slight enhancement. There was focal necrosis in 3 cases， which was consistent with the uneven manifestation of MRI signal in the lesion. Conclusion： The MRI features of testicular non-Hodgkins lymphoma were uniform low signal on T1WI and T2WI， and uniform high signal on DWI. The pathological features of seminiferous tubules destruction， some fibers formation and no abundant capillary network in the stroma were consistent with only mild enhancement on MRI. The typical MRI manifestations may provide evidence for the diagnosis of testicular non-Hodgkins lymphom.

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（收稿日期：2019-08-19）（本文編輯：田婧）