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CT manifestations of gastrointestinal lymphoma of


Abstract Objective: A retrospective analysis of gastrointestinal lymphoma CT scan and enhanced performance. Methods: 21 patients by endoscopic biopsy (7 patients), colonoscopy (3 cases), surgery (8 cases) or cervical lymph node biopsy (3 cases) confirmed lymphoma in the gastrointestinal tract and enhanced CT scan data and analyze the relevant CT. Results: The majority of gastrointestinal lymphoma showed diffuse thickening of the gastrointestinal wall and surrounding lymph node enlargement; aneurysmal expansion and product gas is ileal lesions characteristic manifestations of lymphoma; mucosa-associated lymphoid tissue lymphoma and more found in the stomach, and lesion thickness slightly thinner than other types of lymphoma. Conclusion: CT diagnosis of gastrointestinal lymphoma is an effective method of disease staging a very important value. Chinese papers League finishing. Key words gastrointestinal lymphoma Tomography X-ray computed Analysis of the CT Image of Gastrointestinal Lymphoma ZHANG Ding Wanzhou Hospital, Chongqing 404000, China Abstract: Objective To analyze the CT manifestation of gastrointestinal lymphoma retrospectively. Methods The CT data of 21 cases gastrointestinal lymphoma with verifield by pathology were reviewed retrospectively.To analyze the CT manifestation. Results Lymphadenopathy was found and gastrointestinal wall was diffusely thickened in the most of GI NHL; Aneurysmal dilatation and air in thelesion were the characteristic sign of ileum Lymphoma; MALT were frequently found in stomach than that in other part of gastrointestinal tract. Conclusion CT is a usefull method to diagnose gastrointestinal lymphoma, it is helpful for mapping the extension of gastrointestinal lymphoma. Key word: gastrointestinal; lymphoma; Tomography; X  ray computeed rare primary gastrointestinal lymphoma, gastrointestinal cancer accounts for about 1% to 4%. Which accounts for about 50% of the stomach,[link widoczny dla zalogowanych], small intestine about 20% ~ 54%, colon about 4% to 6%, occurred in the esophagus and rectum are rare [1]. Author from January 1998 to December 2006 in our hospital by pathology or endoscopy, biopsy confirmed 21 cases of gastrointestinal manifestations of malignant lymphoma were retrospectively analyzed CT, CT examination of primary gastrointestinal lymphoma diagnosis. 1 Materials and methods 1.1 General Information 1998 年 1 月 至 2006 年 12 pathologically our hospital or endoscopy, biopsy confirmed 21 cases of GI lymphoma, male 12, female 9, aged 6 years to 75 years, mean 47.5 years old. 10 cases of primary in the stomach, jejunum and ileum in 5 cases, ileocecal and ascending colon in 4 cases, 1 case of rectum and esophagus in 1 case. 1.2 Methods All patients underwent abdominal CT scan, 17 patients added for enhanced scanning. GE sytec1600i type body with CT, scanning parameters for the 120 kV, 160 mAs ~ 240 mAs, slice thickness 10 mm, layer from 8 mm ~ 10 mm. Enhanced scan was iohexol contrast agent, the amount of body weight in kilograms. Check the fast before 6 h, oral administration of warm water before the scan 500 ml ~ 1000 ml, so that the full expansion of gastrointestinal; lesions in the small intestine 30 min before scanning points were oral dose of warm water 1 000 ml ~ 2 000 ml expansion of the small intestine lumen; lesions in the colon by a half-day cleansing enema before the test, scan, 2 h ~ 6 h before oral administration of warm water 1 500 ml ~ 2 500 ml expansion of the intestine. Scan range from the top of the diaphragm to the pubic symphysis. 2 results 2.1 pathology 21 patients, 16 cases of non-Hodgkin's lymphoma, mucosal associated 4 cases of lymphoma, Hodgkin's lymphoma in 1 case. Immunohistochemical staining: B lymphocytes from 18 patients, T lymphocytes derived in 1 case, immunohistochemistry is not marked out in 2 cases. 2.2 CT manifestations 2.2.1 infiltrating of the 10 cases, 5 cases occurred in the stomach, colon in 2 cases, 2 cases of small intestine and esophagus 1 cases. The performance of the gastrointestinal tract and esophagus diffuse or segmental thickening, luminal narrowing, wall thickness 1 cm ~ 10 cm, and the involvement of most or all of the outside wall of weeks. The outline of most of the finishing chamber, most clearly around the fat space, wall softer. 1 case occurred in the colon by colonic wall thickening was asymmetric diffuse segmental, wall soft, bowel showed a tumor-like expansion of the gap clearly adipose cavity (Figure 6). Perigastric fat, 2 cases of unclear swelling; mesenteric root of a large number of lymph nodes, and 2 cases of mesangial swelling; liver and stomach after the ligament area and peritoneal lymph nodes in 3 cases. 8 cases increased significantly enhanced scan showed lesions in 5 cases, mild enhancement in 2 cases, no enhancement in 1 case, enlarged lymph nodes were mild and homogeneous enhancement (Figure 1, Figure 2, Figure 5, Figure 6). 2.2.2 mass type the group of 7 cases, including 2 cases of stomach, small intestine in 3 cases, colon in 2 cases. CT mainly nodular in 4 cases, 2 cases of polypoid or pie in 1 case, 5 cases of single, multiple in 2 cases, large and small diameter of 2 cm ~ 8 cm, with equal or low-density-based. Occurred in the stomach (2 cases) and small intestine (1 case) showed soft tissue density intraluminal mass, smooth edges sharp, plain more uniform density, homogeneous enhancement was significantly enhanced (Figure 3). 3 cases in the small intestine and colon were not only the performance of the entire cavity surface nodules, as ulceration, nodular growth was broad base to the cavity, the border often relatively clear, can be local parietal thickening (Figure 4). Were more clearly polypoid border, broke into the cavity base was narrow, the surface more than the finishing. Accompanied by a large number of retroperitoneal lymph nodes in 1 case, 2 cases of mesenteric lymph nodes roots. Lesions with mild enhancement, low-density area without enhancement in 5 patients; no increase in 2 cases, 1 case of lymph node slight increase. 2.2.3 ulcer occurred in the antrum in 2 cases. In the stomach wall has a ~ 3 Irregular Kanying, ill-defined, infiltrative lesion more limited, cavity gap adjacent organs mostly clear, no obvious abdominal cavity and retroperitoneal lymph nodes (Figure 5). Mild enhancement in 1 case, no enhancement in 1 case. 2.2.4 Hybrid stomach and colon in 1. Showed significant thickening of the local chamber has one or more walls of large ulcers, the border is not clear, the surrounding space was normal or increased density of fat (Figure 4, Figure 6). Ligament area associated with lymph node enlargement of liver and stomach in 1 case, enhanced scan and lymph node lesions mild enhancement.