睾丸非霍奇金淋巴瘤MRI表现与病理特征

李红英

【摘要】 目的：探討睾丸非霍奇金淋巴瘤MRI表现与病理特征。方法：回顾性分析本院2015年3月-2019年2月经手术病理确诊的睾丸非霍奇金淋巴瘤患者35例的临床资料。所有患者均行病理检查与3.0T MRI平扫，其中30例行MRI增强扫描。分析睾丸非霍奇金淋巴瘤MRI表现与病理特征及两者关系。结果：35例患者MRI诊断符合率为85.71%（30/35），5例误诊为睾丸精原细胞瘤。睾丸非霍奇金淋巴瘤MRI表现为T1WI与T2WI呈均匀略低信号，DWI呈均匀高信号。30例行MRI增强扫描，其中27例有轻度均匀强化，3例因坏死呈不均匀轻度强化。病例诊断结果为35例患者中弥漫大B细胞淋巴瘤32例，NK/T细胞淋巴瘤3例。肿瘤细胞弥漫浸润于睾丸实质内，使曲细精管破坏，其间部分纤维形成，间质内无丰富的毛细血管网，与MRI信号较均匀、增强扫描仅呈现轻度强化基本一致。3例有灶性坏死，与病灶MRI信号欠均匀表现一致。结论：T1WI与T2WI呈均匀略低信号，DWI呈均匀高信号为睾丸非霍奇金淋巴瘤MRI特征性表现。曲细精管破坏、其间部分纤维形成、间质内无丰富的毛细血管网的病理特征与MRI增强扫描仅呈现轻度强化一致。典型MRI表现可为睾丸非霍奇金淋巴瘤诊断提供依据。

【关键词】 睾丸 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）（本文編辑：田婧）