Analysis Of Ultrasonographic Manifestations And Misdiagnosis Of Malignant Lymphoma In Children

Objective: To investigate the clinical characteristics,ultrasonography and misdiagnosis of 72 children with malignant lymphoma,in order to improve the understanding of children with lymphoma,and improve the feasibility of detecting lymphoma by ultrasonography.Methods: 32 cases misdiagnosed by ultrasonography and 40 cases of correct diagnosis of children’s lymphoma by ultrasonography were collected,and all cases were confirmed by pathology.The general data was collected including the age and sex,ultrasound examination results,clinical characteristics and so on,and these data were analyzed statistically.Results: Ultrasonographic manifestations of children lymphoma:(1)the neck mass showed the abnormal swelling of one or more lymph nodes,long and short diameter ratio of denotes(L/S)< 2,with a beaded or fused shape,most boundary is neat and clear,the structure of the lymph node door disappeared.(2)The internal echo was relatively uniform,with very low echo or keyed sound,and the middle and low echo can be seen thin line-like strong echo,without calcification and liquefaction.(3)The color Doppler flow imaging(CDFI)showed level Ⅱ~Ⅲ blood flow.Ultrasonographic manifestations of mediastinal lymphoma:The ultrasonic findings of anterior superior mediastinal mass were irregular and hypoechoic.The thymus gland was closely related to the thymus.It was relatively homogeneous,very low echo,no calcification and liquefaction.CDFI: point-like blood flow signal can be seen in it.The anterior and middle mediastinal masses showed hypoechoic mass with clear boundaries and diffuse punctate strong echo.CDFI: marginal blood flow signals can be seen.Ultrasonographic manifestations of intestinal lymphoma:(1)4 cases(4/11,36.3%)of thickening of intestinal wall: manifested as the involvement of the bowel wall,concentric and uneven wall thickening(about 12 ~ 26 mm),the intestinal wall layer structure disappeared,and showed a relatively uniform low echo.(2)6 cases(6/11,54.5%)of mass type: showed sonographic findings of intussusception in abdominal cavity,and the hypoechoic or hypoechoic mass was found in the intestinal wall of the intussusception.The shape was irregular.CDFI: low echo visible blood flow signal.(3)The intestinal canal was mixed in the strip low echo room,the intestinal wall layer can be identified,part of the bowel wall was slightly thickened,and the medium-volume ascites was found.Conclusions 1.The majority of childhood lymphoma is NHL,the cervical lymph nodes and intestinal involvements are more common.2.The possibility of lymphoma should be taken into consideration when the sonographic findings including unexplained lymphadenopathy,intussusception,intestinal root obstruction,abdominal mass,and mediastinal mass.