Plain Film, CT and MR Imaging of Primary Spinal Malignant Lymphoma
CHEN Yingming, JIANG Bo, MA Ling, et al. Department of Radiology, No.1 Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province 510080, P. R. China
Objective To discuss the imaging appearances of primary spinal malignant lymphoma, and to evaluate the diagnostic value of plain film,CT and MR imaging.Materials and Methods 12 patients with pathologically proved primary spinal malignant lymphoma were retrospectively reviewed. Plain film radiography and MR imaging (including plain and contrast) were performed in all cases, CT scan was performed in 5 cases (contrast 3 cases).Results All of the cases were pathologically diagnosed as non-Hodgkin′s lymphoma. Totally 30 vertebrae (cervical 1, thoracic 7, lumbar 2, both thoracic and lumbar 2) were involved, and accessory part destruction was noted in 4 cases, soft tissue mass was found in 10 cases,6 cases were noted with extra-dural masses, pathologic fracture was occurred in 3 cases. X-ray appearance included vertebra destruction, disappearance of pedicle of vertebral arc and compressed fracture. The tumors were isodense to muscle on CT with lytic bone destruction,and were isointense or slightly hypointense on T_1WI compared to muscle and hypointense or isointense or hyperintense on T_2WI compared to bone marrow on non-enhanced imaging. The masses were slightly or moderately enhanced after contrast medium administration both on CT and MRI.Conclusion (1) Most primary malignant spinal lymphomas are non-Hodgkin′s; (2) Tend to involve adjacent vertebrae and create large and moderately enhanced soft tissue masses with less intra-tumor necrosis; (3) Hypointense on MR T_2WI compared to bone marrow may be associates with dense tumor cell and rich fibrosis within the lesion; (4) Extra-dural sleevelet-like mass is a common sign; (5) Plain film contributes limited value to the diagnosis, and MRI is more sensitive than CT in detecting intra-marrow lesions.
【CateGory Index】： R738.1