头颈部嗜酸性淋巴肉芽肿的影像及病理学分析

孔庆聪; 郭媛; 邓星河; 单鸿

doi:10.3760/cma.j.issn.1673-4114.2010.05.017

孔庆聪 , 郭媛 , 邓星河 , 单鸿

文章导航 > 国际放射医学核医学杂志 > 2010, 34 > 5: (313-317)

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头颈部嗜酸性淋巴肉芽肿的影像及病理学分析

1. 510630, 广州, 中山大学附属第三医院放射科;
2. 510630, 广州, 广州市第一人民医院放射科

通讯作者: 单鸿, shanhongsh@163.com

Imaging and pathologic features of eosinophilic hyperplastic lymphogranuloma in head and neck region

Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

Corresponding author: SHAN Hong, shanhongsh@163.com

摘要: 目的探讨头颈部嗜酸性淋巴肉芽肿(KD)的影像表现及病理特征,以提高对该病的术前诊断率。方法回顾性分析8例经病理证实的头颈部KD患者的临床影像及病理表现。结果 8例KD患者中,单发与多发各4例;部位:腮腺6例、口底(颌下腺区)1例、眼睑1例,其中2例累及腹股沟。CT和MRI征象:①累及腮腺者(4例):患侧腮腺、面部弥漫性增大,结节边界欠清或较清,密度略高于腮腺,T₁加权像多为等信号,T₂加权像信号则多为等、低信号,增强扫描有不同程度强化;②累及头颈部其他部位(如颌下腺区、眼睑等)者:病变密度、信号、强化程度亦与累及腮腺者类似,但可有周围组织的受累(如颅骨);③周围淋巴结常不同程度受累、增大,密度、信号均匀,边界清楚,无坏死,无融合;往往累及局部皮下组织,邻近皮肤增厚。病理:KD组织成分基本一致,均由淋巴细胞、嗜酸性粒细胞、小血管和纤维组织以不同比例组成。结论 KD有一定的好发部位和临床特点,结合影像学检查与病理分析,可大大提高其术前诊断的正确率。
- 血管淋巴样增生,嗜酸粒细胞增多性 /
- 头颈部肿瘤 /
- 体层摄影术,X线计算机 /
- 磁共振成像
Abstract: Objective To study the pathological and imaging features of eosinophilic hyperplastic lymphogranuloma (Kimura disease, KD) and improve the diagnosis of the KD. Methods The clinical, imaging and pathological features of 8 cases with KD in head and neck region were retrospectively analyzed. Results In 8 cases with KD, 4 cases had solitary nodule and 4 had multiple masses. 6 patients had soft-tissue masses related to parotid glands, whereas other 2 cases were in relation to the submandibular and eyelid separately.CT and MRI findings: ① Extensive swelling of the involved parotid glands and face were depicted in KD patients. Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the KD. The masses were slightly hyper-density on CT scan. They were iso-intensity in T₁-weighted sequence and iso- or hypo-intensity in T₂-weighted sequence mostly, with different enhancement after administration of contrast medium. ②The masses of KD in other location might involve surrounding structures, such as bone involvement, however they had the similar density, intensity and enhancement pattern with parotid gland. ③All 8 cases had associated lymphadenopathy, which with homogeneous density without necrosis and cyst. Most of their adjacent skin was thicker and subcutaneous fat overlying the subcutaneous masses. Histologic examination demonstrated lymphoid hyperplasia with vascular proliferation and eosinophilic infiltration in the different proportion. Conclusion The position and clinical findings of KD have some characteristic features,with CT, MRI examinations and pathological feature, the accuracy in the diagnosis of KD before operation can be increased.
- Angiolymphoid hyperplasia with eosinophilia /
- Head and neck neoplasms /
- Tomography,X-ray computed /
- Magnetic resonance imaging
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[1]	胡小毅,罗莉.嗜酸性淋巴肉芽肿.国外医学口腔医学分册,2005,32(1):69-70.
[2]	周康,郝玉书.Kimura病.中华血液学杂志,2005,26(4):253-255.
[3]	伍健,张晓萤,陶祥,等.Kimura病7例报道并文献复习.肿瘤防治研究,2009(4):319-321.
[4]	Kimura Y, Pawankar R, Aoki M, et al. Mast cells and T cells in Kimura's disease express increased levels of interleukin-4, interleukin-5, eotaxin and RANTES. Clin Exp Allergy, 2002, 32(12):1787-1793.
[5]	杨智云,赖英荣,冯崇锦,等.颌面区Kimura病CT和MR诊断.临床放射学杂志,2006,25(11):1016-1018.
[6]	丁峰,刘春红,李兴福,等.木村病12例临床分析.中华风湿病学杂志,2007,11(4):225-229.
[7]	Iwai H, Nakae K, Ikeda K, et al. Kimura disease:diagnosis and prognostic factors. Otolaryngol Head Neck Surg, 2007, 137(2):306-311.
[8]	Chen H, Thompson LD, Agnilera NS, et al. Kimura disease:a elinicopathologie study of 21 eases. Am J Surg Pathol, 2004, 28(4):505-513.
[9]	陆磊,陈仁贵,李小秋,等.Kimura病和上皮样血管瘤的临床病理学观察.中华病理学杂志,2005,34(6):353-357.
[10]	Takeishi M, Makino Y, Nishioka H, et al. Kimura disease:diagnostic imaging findings and surgical treatment. J Craniofac Surg, 2007, 18(5):1062-1067.

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头颈部嗜酸性淋巴肉芽肿的影像及病理学分析

通讯作者: 单鸿, shanhongsh@163.com

1. 510630, 广州, 中山大学附属第三医院放射科;
2. 510630, 广州, 广州市第一人民医院放射科

收稿日期: 2010-04-18

关键词:

摘要: 目的探讨头颈部嗜酸性淋巴肉芽肿(KD)的影像表现及病理特征,以提高对该病的术前诊断率。方法回顾性分析8例经病理证实的头颈部KD患者的临床影像及病理表现。结果 8例KD患者中,单发与多发各4例;部位:腮腺6例、口底(颌下腺区)1例、眼睑1例,其中2例累及腹股沟。CT和MRI征象:①累及腮腺者(4例):患侧腮腺、面部弥漫性增大,结节边界欠清或较清,密度略高于腮腺,T₁加权像多为等信号,T₂加权像信号则多为等、低信号,增强扫描有不同程度强化;②累及头颈部其他部位(如颌下腺区、眼睑等)者:病变密度、信号、强化程度亦与累及腮腺者类似,但可有周围组织的受累(如颅骨);③周围淋巴结常不同程度受累、增大,密度、信号均匀,边界清楚,无坏死,无融合;往往累及局部皮下组织,邻近皮肤增厚。病理:KD组织成分基本一致,均由淋巴细胞、嗜酸性粒细胞、小血管和纤维组织以不同比例组成。结论 KD有一定的好发部位和临床特点,结合影像学检查与病理分析,可大大提高其术前诊断的正确率。

English Abstract

Imaging and pathologic features of eosinophilic hyperplastic lymphogranuloma in head and neck region

Corresponding author: SHAN Hong, shanhongsh@163.com

Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China

Received Date: 2010-04-18

Abstract: Objective To study the pathological and imaging features of eosinophilic hyperplastic lymphogranuloma (Kimura disease, KD) and improve the diagnosis of the KD. Methods The clinical, imaging and pathological features of 8 cases with KD in head and neck region were retrospectively analyzed. Results In 8 cases with KD, 4 cases had solitary nodule and 4 had multiple masses. 6 patients had soft-tissue masses related to parotid glands, whereas other 2 cases were in relation to the submandibular and eyelid separately.CT and MRI findings: ① Extensive swelling of the involved parotid glands and face were depicted in KD patients. Both well-defined, nodular masses, as well as ill-defined plaque-like infiltrative masses were seen in the KD. The masses were slightly hyper-density on CT scan. They were iso-intensity in T₁-weighted sequence and iso- or hypo-intensity in T₂-weighted sequence mostly, with different enhancement after administration of contrast medium. ②The masses of KD in other location might involve surrounding structures, such as bone involvement, however they had the similar density, intensity and enhancement pattern with parotid gland. ③All 8 cases had associated lymphadenopathy, which with homogeneous density without necrosis and cyst. Most of their adjacent skin was thicker and subcutaneous fat overlying the subcutaneous masses. Histologic examination demonstrated lymphoid hyperplasia with vascular proliferation and eosinophilic infiltration in the different proportion. Conclusion The position and clinical findings of KD have some characteristic features,with CT, MRI examinations and pathological feature, the accuracy in the diagnosis of KD before operation can be increased.