摘要目的 探讨不同病理类型的鼻部和咽部淋巴瘤的影像学征象,以提高其诊断准确率.方法 回顾性分析经病理证实的32例鼻部和咽部非霍奇金淋巴瘤(NHL)的影像学资料(CT或MR),按病理类型分为NK/T细胞型及B细胞型两组. 分析两组病例的发病部位、范围、形态、生长方式、邻近组织情况等,并对两组统计结果进行 χ2检验. 结果 NK/T 细胞型 NHL 共12例(37.5%),10例(83.3%)以鼻腔为主,2例(16.7%)以咽淋巴环为主,鼻腔型表现为鼻腔内软组织呈铸型生长. 其中7例(58.3%)出现表面小溃疡,6例(50.0%)出现邻近软组织侵犯及骨质破坏, 2例(16.7%)见颈部淋巴结转移. B 细胞型 NHL 共20例(62.5%),发生于咽淋巴环者19例(95.0%),发生于鼻腔者1例(5.0%),表现为咽淋巴环软组织增厚,匍匐状生长. 咽旁间隙受累及骨质破坏2例(16.7%);颈部淋巴结转移20例(100%). 经χ2检验,鼻部和咽部NK/T细胞较B细胞NHL更好发于鼻腔(χ2=20.401,P=0.000),铸型生长,更易破坏邻近软组织及骨质(χ2=6.400, P=0.011)及出现小溃疡(χ2=11.378,P=0.001);而弥漫大B细胞淋巴瘤更易发生于在咽淋巴环,匍匐状生长(χ2=20.519,P=0.000),更多存在淋巴结累及(χ2=23.058,P=0.000). 结论 不同病理类型的鼻及咽部原发性NHL影像学上具有特征性的表现,具有辅助诊断价值.

abstractsObjective To investigate the distinct imaging features of different pathological subtypes of non-Hodgkin's lymphomas(NHL)of the nose and pharynx and to improve its diagnostic accuracy.Methods A retrospective study was performed on the imaging materials(including CT or MRI)of 32 patients who were con-firmed as NHL of the nose and pharynx by pathology.The materials were divided into two groups:NK/T cell lym-phoma(NKTCL)and B cell lymphoma(BCL).The characteristics of the site,size,morphology,growth pattern,re-gional structure invasion of these lymphomas were evaluated and compared.The results were analyzed by Chi-quare test.Results A total of 12 cases(37.5%)were NK/T cell type,10 cases(83.3%)mainly had nasal cavity involvement,2 cases(16.7%)showed Waldeyer's ring involvement,which were characterized by nasal soft tissue with mold growth.Among these,7 cases(58.3%)had superficial ulcerations,6 cases(50.0%)with regional struc-ture invasion,2 cases(16.7%)lymph node involvements.Besides,20 cases(62.5%)were B cell type NHL.A-mong these,19 cases(95.0%)had Waldeyer's ring involvement and 1 case(5.0%)occurred in nasal cavity with pharyngeal lymphatic loop soft tissue incrassation,and 2 cases(16.7%)had regional structure involvement of pharyngeal space and bone.All cases showed cervical lymphadenopathy.Results of the Chi-square test showed that NKTCL had a higher incidence of nasal cavity involvement than B cell type NHL(χ2=20.401,P=0.000) and regional structure invasion(χ2=6.400,P=0.011),as well as superficial ulcerations (χ2=11.378,P=0.001).BCL had a higher incidence of Waldeyer's ring involvement and creeping growth pattern(χ2=20.519, P=0.000),as well as lymphadenopathy(χ2=23.058,P=0.000)compared to NKTCL.Conclusion Primary NHLs of the nose and pharynx of different pathological subtypes has some characteristics on imaging,which may have supplementary value in the lymphoma diagnosis.