Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Typical and Atypical Imaging Features of Malignant Lymphoma in the Abdomen and Mimicking Diseases

복부 악성 림프종의 영상 소견 및 비슷한 소견을 보일 수 있는 질병들

  • Jong Eun Kim (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • So Hyun Park (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Young Sup Shim (Department of Radiology, Gil Medical Center, Gachon University College of Medicine) ;
  • Sungjin Yoon (Department of Radiology, Gil Medical Center, Gachon University College of Medicine)
  • 김종은 (가천대학교 의과대학 길병원 영상의학과) ;
  • 박소현 (가천대학교 의과대학 길병원 영상의학과) ;
  • 심영섭 (가천대학교 의과대학 길병원 영상의학과) ;
  • 윤성진 (가천대학교 의과대학 길병원 영상의학과)
  • Received : 2023.02.07
  • Accepted : 2023.05.06
  • Published : 2023.11.01
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Abstract

Malignant lymphoma typically presents with homogeneous enhancement of enlarged lymph nodes without internal necrotic or cystic changes on multiphasic CT, which can be suspected without invasive diagnostic methods. However, some subtypes of malignant lymphoma show atypical imaging features, which makes diagnosis challenging for radiologists. Moreover, there are several lymphoma-mimicking diseases in current clinical practice, including leukemia, viral infections in immunocompromised patients, and primary or metastatic cancer. The ability of diagnostic processes to distinguish malignant lymphoma from mimicking diseases is necessary to establish effective management strategies for initial radiological examinations. Therefore, this study aimed to discuss the typical and atypical imaging features of malignant lymphoma as well as mimicking diseases and discuss important diagnostic clues that can help narrow down the differential diagnosis.

악성 림프종은 역동적 조영증강 컴퓨터단층촬영에서 전형적으로 커진 림프절 이 균일한 조영증강을 보이며 내부에 괴사 및 낭성 병변을 보이지 않는 영상 소견을 보이며, 이를 통해 침습적인 진단 검사 없이도 의심할 수 있다. 그러나 일부 림프종은 비전형적인 영상 소견을 보여 영상의학과 의사가 진단하는데 어려움을 겪는다. 더욱이, 실제 임상 현장에서는 백혈병, 면역저하자의 바이러스 감염, 원발암 및 전이암들이 림프종과 유사하게 보여 감별진단하는데 어려움이 있다. 초기에 영상검사로 악성 림프종과 이러한 유사질환을 구별하는것은 적절한 치료방침을 결정하는데 중요하다. 따라서, 본 임상 화보의 목표는 림프종의 전형적, 비전형적 영상 소견과 림프종을 모방하는 병변들의 영상 소견을 보여주며, 감별 진단을 좁히는데 도움이 되는 중요한 소견들을 논의하고자 한다.

Keywords

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