【摘要】 目的　探讨胃肠道原发性淋巴瘤的影像学检查方法、诊断、鉴别诊断及与病理的关系。资料与方法　搜集经手术病理或内镜活检证实 ,并有较完整的消化道造影、部分CT检查资料以及部分手术后标本涂钡摄片的胃肠道恶性淋巴瘤 2 9例 ,包括胃 2 0例 ,十二指肠 1例 ,小肠 5例 ,结肠 3例。结果　上胃肠道气钡双重造影检查 ,2 0例胃原发性淋巴瘤中单个较大的不规则形充盈缺损 9例 ,7例形成“牛眼”征 ;多个大小不等卵石样充盈缺损 6例 ;单个巨大溃疡 3例 ,1例表现为典型的“半月综合征” ;多个大小不等浅淡龛影 2例 ;7例胃腔变形 ,胃壁柔软 ,蠕动减弱 ,与以上各类型并存。 1例十二指肠原发性淋巴瘤表现为多个大小不等的充盈缺损伴条形龛影。 5例小肠原发性淋巴瘤 ,肠腔狭窄、狭窄段以上肠管扩张 2例 ,3例仅表现为小肠套叠。 3例结肠原发性淋巴瘤 ,肠腔对称性环形狭窄 1例 ,肠腔非对称性充盈缺损伴龛影形成 2例。 4例胃原发性淋巴瘤CT平扫及增强扫描 ,1例弥漫性胃壁增厚 ,增强后胃壁强化明显 ;3例腔内不规则形肿块 ,增强后明显均匀强化。 4例中 3例胃周脂肪间隙欠清晰。 2例结肠原发性淋巴瘤CT表现为一侧肠壁见软组织肿块影 ,增强后明显均匀强化。 2 9例病理组织学结果 ,非霍奇金淋巴瘤 2 8例 ,其中B细胞性 2 5例 ,T更多还原

【Abstract】 Objective To discuss the imaging method, diagnosis and differentiation of primary gastrointestinal lymphoma, to study the correlation between imaging findings and pathology.Materials and Methods Twenty-nine patients with pathologically or endoscopically proved primary gastrointestinal lymphomas were enrolled in this study. These cases had rather intact double-contrast barium meal materials, and some cases had CT scans and/or barium-covered surgical specimens pictures. The malignant gastrointestinal lymphomas were developed in the stomach (n=20), duodenum (n=1), small intestine (n=5) and colon (n=3). The imaging findings were retrospectively analyzed, and compared with pathologic results.Results On double-contrast barium meal exam, the primary gastric lymphoma (n=20) was characterized by single big irregular filling-defect (n=9), “bull’s eye” sign (n=7), “cobblestone appearance” sign (n=6), single huge ulcer (n=3) with typical crescent sign (1/3), multiple different sized shallow ulcers (n=2) and deformed gastric cavity (n=7), etc. Of 5 cases of primary small intestinal lymphoma, stricture of intestinal cavity with dilatation of the proximal loop was seen in 2, and intestinal intussusception in 3. Of 3 cases with primary lymphoma of the colon, annular stricture of the colon was seen in one and asymmetrical filling-defect with ulceration in 2. Of 4 cases with primary gastric lymphoma had both plain and enhanced CT scanning, one showed diffusely thickened gastric wall with obvious enhancement, and 3 had irregular mass with marked homogeneous enhancement. Blurred perigastric fat layer was seen in 3 cases. Two cases of primary colonic lymphoma showed soft-tissue mass on the colonic wall with obvious enhancement. Pathologically, Hodgkin’s disease was confirmed in one case and non-Hodgkin’s lymphoma in 29 cases, of which B-cell type was seen in 25 and T-cell type in 3.Conclusion Double-contrast barium meal exam is of choice in the diagnosis of primary gastrointestinal lymphoma. CT scanning is an effective supplement for double-contrast barium meal exam, which can display the involvement of the intestinal wall, the extent of the lesion and metastatic lymphadenopathy, and can help make the TNM staging.更多还原