A 56-year-old man with history of chronic hepatitis C and low-risk prostate cancer presents with periumbilical pain for the last week.
56岁男性,既往有慢性丙肝、低风险前列腺癌。现脐周痛一周。
1.There is conglomerate retroperitoneal lymphadenopathy.
腹膜后淋巴结肿大并相互融合。
True
False
2.The spleen is nodular in contour.
脾脏边缘呈结节状。
True
False
3.There is an occlusive inferior vena caval thrombus.
下腔静脉血栓闭塞。
True
False
4.There is a rind of hypodense tissue around the visualized upper renal poles.
肾上极可见低密度组织包绕。
True
False
5.There are hypodense hepatic lesions.
肝内可见低密度病灶。
True
False
6.The attenuation pattern of the spleen is most likely related to which of the following?
脾脏的异常密度是由下列哪项所致?
Physiologic enhancement 正常生理性强化
Chronic post-traumatic changes 外伤后慢性改变
Multifocal hemangiomas 多发血管瘤
Neoplastic involvement 肿瘤侵犯
7.Which of the following is the most likely diagnosis?
最有可能的诊断是下列哪项?
Metastatic hepatocellular carcinoma 转移性肝细胞型肝癌
Metastatic prostate cancer 转移性前列腺癌
Lymphoma 淋巴瘤
Abdominal tuberculosis 腹部结核
Reactive lymphadenopathy from inflammatory bowel disease 肠道炎性病变反应性淋巴结肿大
Additional Questions
8.The majority of lymphomas originate from which the following lymphocyte types?
大部分淋巴瘤起源于哪种淋巴细胞?
B cells
T cells
9.Mesenteric lymphadenopathy is more common in which of the following?
腹膜后淋巴结肿大最常见于下列哪种淋巴瘤?
Hodgkin\’s lymphoma
Non-Hodgkin\’s lymphoma
10.Infection with the hepatitis C virus (HCV) has been associated with increased risk for non-Hodgkin\’s lymphoma.
丙肝病毒感染可能会增加非霍奇金淋巴瘤的患病几率。
True
False
11.Patients with chronic hepatitis C have a higher risk of developing lymphoma than hepatocellular carcinoma.
慢性丙肝的患者发生淋巴瘤的几率高于肝细胞型肝癌。
True
False
选择题答案:
True
True
False
False
True
Neoplastic involvement
Lymphoma
B cells
Non-Hodgkin\’s lymphoma
True
False
Findings and Diagnosis
Findings
Contrast-enhanced CT demonstrates markedly enlarged, hypoattenuating conglomerate upper abdominal retroperitoneal and mesenteric lymphadenopathy (best demonstrated on coronal images). There are multifocal hypodense lesions throughout the spleen, which is enlarged and nodular in contour, reflecting lymphomatous involvement. There are a few small hypodense lesions in the liver, the most prominent in segment VI, which were incompletely characterized, but favored to represent hepatic lymphomatous involvement given the lymphadenopathy and splenic involvement. The patient was subsequently confirmed to have diffuse large B-cell lymphoma.
Abnormal proliferation of mature lymphocyte population.
成熟淋巴细胞数量的异常增多
Spectrum of disease or multiple subtypes: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype and can occur as primary disease or transformation from indolent lymphoma.
弥漫性大B细胞淋巴瘤(DLBCL)是最常见的亚型,可以是首发,也可以由惰性淋巴瘤转化而来。
HCV-associated lymphoma
Clinical association with various viral infections is well-described, including Epstein-Barr virus (EBV), human T-lymphotropic virus 1 (HTVL-1), human immunodeficiency virus (HIV), hepatitis C virus (HCV), and herpes simplex virus (HSV)