Giant lymph node hyperlasia and its combined paraneoplastic pemphigus: the clinical, histo-pathology and CT findings / 肿瘤研究与临床

ABSTRACT

Objective To explore the CT findings, the clinicopathological features of giant lymph node hyperlasia and its combined paraneoplastic pemphigus. Methods The clinical features,the imaging and the follow-up data of 19 patients surgically confirmed as giant lymph node hyperlasia were analyzed. Results Clinically, the majority of patients not accompanied with paraneoplastic pemphigus abnormal pulmonary,showed asymptomatic, and only a very small number had lower abdominal discomfort or pain.The patients associated with paraneoplastic pemphigus and abnormal pulmonary manifested the special clinical manifestations, CT finding, pathological characteristics. Histopathologically, the hyaline-vascular type was found in 18 cases and mixed type in 1 case. CT scanning showed that the lesions in 18 patients appeared as larger(2.5-15 cm in diameter), solitary, cylindrical soft-tissue masses with marked enhancement. One case was presented as multiple enlarge lymph node at left neck (1.5-5 cm in diameter). Seventeen of 19 cases were smooth at the edge, and ten cases were uniform in density. The calcification was characterized of an arborizing and (or) flocculent pattern and central location in 7 cases, of which, 1 case circumferential distribution and 5 cases scattered with multiple spots or strip. Shapes were cylindrical and spherical or elliptical. All patients with giant lymph node hyperlasia showed marked enhancement after contrast administration at arterial phase and delay scan. Conclusion CT scanning is an effective method in diagnosis, guiding surgery and evaluating prognosis of giant lymph node hyperlasia, especially dynamic contrast-enhanced and delayed CT scanning. It is the critical way for patients complicated with paraneoplastic pemphigus and abnormal pulmonary cases, to diagnose early and resect tumor-like lesions in vivo.