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《Journal of China Clinic Medical Imaging》 2006-05
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The imaging diagnosis of primary lymphoma of bone

GONG Yong-jin1, ZHOU Jian-jun2, ZHOU Kang-rong2 (1. Department of Radiology, the People's Hospital of Xianju, Xianju Zhejiang 317300, China; 2. Zhongshan Hospital, Fudan University, Shanghai 200032, China)  
Objective: Exploring the imaging features of lymphoma of bone and evaluating their clinical value. Materials and Methods: Thirteen patients of lymphoma confirmed by surgery and pathology underwent conventional radiography, in whom 10 underwent CT scan, and 9 underwent MR imaging. The acquired images were reviewed and analysed retrospectively and correlated with surgical and pathological results. Results: Nine non-Hodgkin's and 4 Hodgkin's lymphoma affected spine(46%), acetabulum(15%) and long bones(39%) respectively. Common locations were the vertebral body of spine and diaphysis of a major long bone. Common appearances were a lytic(69%) and mixed-density(31%) lesion with most cases showing an infiltrative or moth-eaten pattern. Cortical destruction was seen in 11 parients(85%) but usually without extensive cortical destruction. Periosteal reaction was seen in 3 patients(23%). Soft-tissue masses were present in 7 patients(54%). Lymphomas are hypo-dense or isodense to muscle on CT with circumscribed or distinct margins. Lymphomas appear low in signal intensity on T1-weighted images and low to high in signal intensity on T2-weighted images. Soft-tissue masses appear low in signal intensity on T1-weighted images and slightly high in signal intensity on T2-weighted images without much variable and with usually mild, enhancement following Gadolinium-DTPA(Gd-DTPA) contrast material injection. Conclusion: Lymphoma of bone has an infiltrative or moth-eaten pattern lytic bone destruction associated with soft-tissue mass. Radiography, CT and MR imaging can suggest the diagnosis, particularly when slightly high in signal intensity on T2-weighted images of a soft-tissue mass without extensive cortical destruction.
【CateGory Index】: R738
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