子宫弥漫大B细胞淋巴瘤1例

Diffuse Large B-Cell Lymphoma of the Uterus: A Case Report

摘要: 目的：通过病例回顾，提高对子宫弥漫大B细胞淋巴瘤的认识、诊断和治疗。方法：总结1例经病理证实的子宫淋巴瘤患者的临床资料，并复习相关文献资料。结果：患者临床表现为右侧腰部肿块，伴右侧腰疼。CT示子宫腔内见类圆形团块状影，最大截面约为47 mm × 43 mm，增强呈轻度强化；子宫顶部见类圆形混杂密度影，其内见多发点状钙化影。MR示宫颈部见团块状稍长T1稍长T2信号，直径约44 mm，病灶向上生长，DWI呈高信号，增强呈明显不均匀强化，延迟期呈低信号，右侧髂血管旁及腹膜后见多发肿大淋巴结。子宫顶部见类圆形长T1短T2信号。术后病理确诊为宫腔弥漫大B细胞淋巴瘤。结论：子宫弥漫大B细胞淋巴瘤发生率极低，影像表现具有一定特征性，综合其临床、影像表现可提高诊断率，但确诊仍依赖于病理。

Abstract: Objective: To improve the understanding, diagnosis and treatment of diffuse large B-cell lymphoma of the uterus through the cases review. Methods: The clinical data of a case of pathologically-proved diffuse large B-cell lymphoma of the uterus was reported and relevant literatures were reviewed. Results: The patient felt a lump in the right waist with back pain. CT showed a circular mass shadow in the uterine cavity, and the maximum cross-section was about 47 mm × 43 mm, and the tumor was slightly enhancing. On the top of the uterus, there was a roundish and mixed-density shadow with punctate calcifications. MR showed a slightly longer T1 and slightly longer T2 signal mass shadow in the cervix with a diameter of 44 mm. The lesion grew upward. It showed high signal on DWI, significantly inhomogeneous enhancement, and delayed stage showed low signal. Multiple en-larged lymph nodes were seen around the right iliac vessel and retroperitoneum. A long T1 and short T2 signal round shadow were seen at the top of the uterus. The pathological diagnosis of the gallbladder lesion was diffuse large B-cell lymphoma of the uterus. Conclusion: The incidence of large B-cell lymphoma of the uterus is extremely low, and the imaging manifestations have certain characteristics. The overall clinical data and imaging manifestations can improve the diagnosis rate, but its diagnosis still depends on the pathology.