中国临床医学影像杂志2025，Vol.36Issue(2)：104-108,5.DOI:10.12117/jccmi.2025.02.007
前纵隔弥漫大B细胞淋巴瘤与胸腺癌的CT特征对比分析
Comparative analysis of CT features of diffuse large B-cell lymphoma in the anterior mediastinum and thymic carcinoma
摘要
Abstract
Objective:To compare and analyze the CT characteristics of diffuse large B cell lymphoma(DLBCL)and thymic carcinoma in order to improve the differential diagnostic ability between the two diseases.Methods:Forty-eight pa-tients(19 males,29 females;age range 17～81 years,median age 53.0 years(Q1:36.0;Q3:61.8))with anterior mediastinal DL-BCL and thymic carcinoma confirmed by surgical resection or biopsy with pathological diagnosis were retrospectively collected from April 2009 to February 2023 in our hospital.All cases underwent chest CT plain and enhanced examinations before pathological confirmation.CT findings including lesion location,morphology,margins,density,degree of enhancement,surround-ing invasion,necrosis area were reviewed respectively.Statistical analysis was carried out to compare the CT features of the two groups.Results:A total of 18 cases of anterior mediastinal DLBCL(4 males,14 females;age range 17～81 years,median age 35.5 years(Q1:29.0;Q3:50.3))and 30 cases of thymic carcinoma(15 males,15 females;age range 19～71 years,57.0 years(Q1:51.5;Q3:64.5))were included.There was no statistically significant difference between the two groups in midline-crossing,lesion morphology,and invasion of adjacent structures(P=0.052;P=0.215;P=0.582).The differences in mediastinal vascular wrapping,pleural thickening,and pleural effusion were statistically significant(P=0.003;P=0.011;P=0.017).76.7%(23/30)of thymic carcinomas and 88.9%(16/18)of DLBCL showed heterogeneous enhancement(P=0.294).The thymic carcinomas exhibited more internal calcification and significant enhancement compared to DLBCL(P=0.005;P<0.001).There was no statisti-cally significant difference between the two groups in terms of internal necrosis and the proportion of necrotic areas(P=0.199;P=0.063);the clear demarcation of necrotic areas as"pseudo-cystic sign"was observed in 50%(8/16)of DLBCL cases,signif-icantly higher than 13.6%(3/22)in the thymic carcinoma group(P=0.012).Conclusion:Anterior mediastinal DLBCL and thymic carcinoma both exhibit characteristic MSCT features.DLBCL often presents with midline-crossing,growth,vascular encasement and a"pseudo-cystic sign",while thymic carcinoma frequently involves pleural invasion,internal calcification and marked en-hancement.The aforementioned thoracic MSCT findings are helpful for differential diagnosis between the two diseases.关键词
淋巴瘤,大B细胞,弥漫性/胸腺肿瘤/体层摄影术,螺旋计算机Key words
Lymphoma,Large B-Cell,Diffuse/Thymus Neoplasms/Tomography,Spiral Computed分类
临床医学引用本文复制引用
郑钊文,段晓蓓,林茵,陈小娟,聂中新,陈相猛..前纵隔弥漫大B细胞淋巴瘤与胸腺癌的CT特征对比分析[J].中国临床医学影像杂志,2025,36(2):104-108,5.基金项目
国家自然科学基金面上项目(62176104) （62176104）
北京医学奖励基金(YXJL-2023-0866-0324). （YXJL-2023-0866-0324）
