中国临床医学影像杂志2024,Vol.35Issue(12) :851-855.DOI:10.12117/jccmi.2024.12.004

儿童腹部伯基特淋巴瘤临床与CT表现及误诊原因分析

Analysis of misdiagnosis reasons for clinical and CT manifestations of abdominal Burkitt's lymphoma in children

朱敏 黄雯静 鹿连伟 蔡培珊 吴慧莹
中国临床医学影像杂志2024,Vol.35Issue(12) :851-855.DOI:10.12117/jccmi.2024.12.004

儿童腹部伯基特淋巴瘤临床与CT表现及误诊原因分析

Analysis of misdiagnosis reasons for clinical and CT manifestations of abdominal Burkitt's lymphoma in children

朱敏 1黄雯静 1鹿连伟 1蔡培珊 1吴慧莹1
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作者信息

  • 1. 广州医科大学附属妇女儿童医疗中心放射科,广东 广州 510623
  • 折叠

摘要

目的:总结儿童腹部伯基特淋巴瘤(Burkitt's lymphoma,BL)的临床及CT特征并分析CT误诊原因,提高儿童腹部BL的诊断水平.方法:回顾性收集经病理证实的71例儿童腹部BL的临床及42例治疗前CT资料.分析71例儿童腹部BL的临床特征、42例治疗前CT特征及误诊原因.结果:71例BL中,男60例,女11例,平均年龄(6.8±0.1)岁,早期24例(Ⅰ+Ⅱ期,33.8%),晚期47例(Ⅲ+Ⅳ期,66.2%),总体缓解63例(88.7%),死亡8例(12.3%).42例治疗前行全腹部CT平扫及增强扫描.儿童腹部BL累及胃肠道31例(73.8%),合并周围器官浸润20例(47.6%).治疗前CT诊断符合率为81%.根据CT误诊原因,把儿童腹部BL分为胃肠型、结型和混合型.其中胃肠型14例(33.3%),表现为肠(胃)壁弥漫性增厚.结型15例(35.7%),以软组织肿块为主,肠壁增厚不显著.混合型13例(31.0%),同时出现肠壁弥漫性增厚及淋巴结肿大,且泌尿系统浸润较胃肠型及结型更常见(P=0.024).结论:儿童腹部BL常累及胃肠道,以肠(胃)壁弥漫性增厚及/或合并软组织肿块为特征,易合并周围组织浸润.胃肠型容易误诊为间质瘤,结型容易误诊为恶性肿瘤,混合型具有典型影像学表现,绝大部分可以准确诊断.

Abstract

Objective:To summarize the clinical and CT characteristics of abdominal Burkitt's lymphoma (BL) in children,analyze the causes of misdiagnosis,and improve the diagnostic accuracy of abdominal BL in children. Methods:A retrospec-tive analysis focused on 42 children with pre-therapy CT data and 71 with clinical data of abdominal BL. The clinical char-acteristics of 71 cases of abdominal BL in children were studied,as well as the CT characteristics of 42 cases and as well as the causes of misdiagnosis. Results:Of the 71 children with abdominal BL,60 were males and 11 were females,with an av-erage age of 6.8±0.1 years. Among them,24 cases were in the early stage(Ⅰ+Ⅱ,33.8%) and 47 cases were in the late stage (Ⅲ+Ⅳ,66.2%). Sixty-three cases(88.7%) showed overall remission,and 8 cases(12.3%) died. Before therapy,42 cases under-went plain and enhanced abdomen CT scans. A total of 31 cases(73.8%) had gastrointestinal tract involvement,while 20 cases (47.6%) had peripheral organ invasion. The accuracy rate of CT diagnosis before treatment was 81%. Children 's abdominal BL was divided into three types according to the cause of the CT misdiagnosis:gastrointestinal type,nodular type,and hybrid type. Fourteen cases of gastrointestinal type(33.3%) displayed diffuse thickening of the intestinal(gastric) wall. Fifteen cases of nodule type (35.7%) displayed soft tissue masses with no significant intestinal wall thickening. Thirteen cases of hybrid type (31.0%) displayed diffuse thickening of the intestinal wall and lymph node enlargement,and urinary system infiltration was more common than gastrointestinal and nodule type (P=0.024). Conclusion:Abdominal BL in children often involves the gas-trointestinal tract and is characterized by diffuse thickening of the intestinal (gastric) wall and soft tissue masses,which are prone to peripheral tissue infiltration. The gastrointestinal type is easily misdiagnosed as a stromal tumor,the nodular type is easily misdiagnosed as a malignant tumor,and the hybrid type has typical imaging manifestations,most of which can be ac-curately diagnosed.

关键词

伯基特淋巴瘤/腹部肿瘤/儿童/误诊/体层摄影术,X线计算机

Key words

Burkitt Lymphoma/Abdominal Neoplasms/Child/Diagnostic Errors/Tomography,X-ray Computed

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出版年

2024
中国临床医学影像杂志
中国医学影像技术研究会,中国医科大学

中国临床医学影像杂志

CSTPCDCSCD北大核心
影响因子:1.204
ISSN:1008-1062
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