Imaging of Lymph Nodes in the Head and Neck Region

2006 ◽  
Vol 10 (4) ◽  
pp. 3-8
Author(s):  
C. Czerny ◽  
C. Krestan ◽  
M. Formanek
2019 ◽  
Vol 52 (4) ◽  
pp. 268-271
Author(s):  
Pinar Gulmez Cakmak ◽  
Gülsüm Akgün Çağlayan ◽  
Furkan Ufuk

Abstract Primary extranodal lymphoma is defined as a lymphoma at a solitary extranodal site, with or without involvement of the lymph nodes. The clinical and radiological features of extranodal lymphoma have been documented in recent studies. In this pictorial essay, we reviewed imaging findings of extranodal lymphoma in the head and neck region.


2020 ◽  
Vol 28 (2) ◽  
pp. 144-150
Author(s):  
Vandana P Thorawade ◽  
S A Jaiswal ◽  
Seema Ramlakhan Gupta

Introduction  Tuberculosis can involve any organ or site. Otorhinolaryngologist may encounter tuberculosis affecting lymph nodes, ear, larynx, deep neck spaces, salivary glands etc. which can mimic other chronic granulomatous conditions or malignancy. To ensure early diagnosis, it is important to recognize its cardinal signs and symptoms and to be aware of potential pitfalls in diagnosis. This study was done to learn the clinical presentation of tuberculosis in ear, nose, throat and head and neck region, and to assess the effectiveness of various investigations and treatment done for the same. Materials and Methods  A retrospective study done in our institution involving 120 patients suffering from tuberculosis in ear, nose, throat and head and neck region who attended pulmonary medicine or ENT OPD or ward between January 2008 to December 2017 that is, 10 years. Study period for data collection and analysis was 1 month. Results Total 120 patients-69 males and 51 females. Most common site was cervical lymph nodes(77.5% patients), followed by larynx(8.3%),middle ear(7.5%),deep neck spaces(2.5%) and salivary glands and nose(1.7% each). Histopathology was highly sensitive(99. 1%).All except one patient responded to first-line antitubercular drugs, the other patient was given treatment for MDR-TB to which he responded. Conclusion Tuberculosis can involve any site in the head and neck region, most common being cervical lymph nodes mainly presenting as neck swelling. Variable nature of manifestations of tuberculosis makes it essential to have high degree of suspicion for early diagnosis.


Author(s):  
Dr. Bipin Gandhi

INTRODUCTION: Lesions in head and neck have always been a diagnostic dilemma for a pathologist and a treating clinician. Being on the exposed part of body, they become cosmetically unacceptable. These include lesions arising from the regional group of lymph nodes. Most commonly lymphadenopathy is a common clinical presentation. The diagnostic probability ranges from infections to developmental abnormalities, from inflammatory to malignant lesions. None the less all the lesions in lymph nodes of the head and neck region cannot be limited to a particular age group and gender. Routine staining procedures like PAP, Giemsa, Field and even H & E has been used to clinch the pathogenesis of the lesion. It can be said without any fear of contradiction that FNAC is certainly a very important tool for an early diagnosis of not only head and neck lesions but also other lesions elsewhere in the body. MATERIAL AND METHODS: This is a comparative study which was conducted in the department of pathology. The patients were subjected to detailed history and thorough clinical examination according to the working proforma. Patients were subjected to FNAC after written informed concent. The slides were stained using PAP, Giemsa and H&E stain and examined for underlying pathology. A detailed gross examination was done and 3-15 sections were selected from the representative areas for routine paraffin sections.  RESULTS: Amongst the total of 296 patients aspirated, 127 were from Lymph Nodes of head and neck region. Cervicallymph nodes were the most common group of lymph nodes aspirated, followed by submandibular and submental lymph nodes. Age wise tabulation shows maximum frequency of inflammatory lesions at younger age, of  which reactive hyperplasia was more common in pediatric age group and tuberculous lesions were more common in 20-40years of age. CONCLUSION: Cervical lymph nodes were the most common group of lymph nodes aspirated, followed by submandibular and submental lymph nodes. Reactive lymphadenitis is the most frequent diagnosis amongst the lymph node lesions and tuberculous lesions was the second most common diagnosis amongst all the lymph node lesions. 35 cases out of 127, as tuberculous lymphadenitis. Histopathology correlation could be done in 36 cases, of which 32 were found be correctly diagnosed in cytology.


2000 ◽  
Vol 79 (3) ◽  
pp. 195-199 ◽  
Author(s):  
Sebastian J. Karavattathayyil ◽  
John R. Krause

Kimura's disease is a rare, idiopathic condition that usually affects young men of Asian descent. The disease is characterized by swelling and lesions in the head and neck region, with involvement of the subcutaneous soft tissue, major salivary glands, and lymph nodes. Patients almost always have eosinophilia and elevated serum immunoglobulin E levels. The diagnosis is established by biopsy. Kimura's disease is usually self-limiting. Its etiology is unknown but is thought to be a manifestation of an aberrant allergic response. In this paper, we describe the case of a 30-year-old patient who was diagnosed with Kimura's disease at our institution.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Chintamaneni Raja Lakshmi ◽  
M. Sudhakara Rao ◽  
A. Ravikiran ◽  
Sivan Sathish ◽  
Sujana Mulk Bhavana

The aim of the current study is to determine the efficacy of ultrasound in differentiating between benign and metastatic group of cervical lymph nodes. The study included forty-five subjects who were divided into three groups with 15 in each, by stratified random sampling method. Group 1 comprised fifteen patients without signs and symptoms of any infection and neoplasms in head and neck region (control group). Group 2 included fifteen patients with signs and symptoms of malignancy in head and neck region. Group 3 consisted of fifteen patients with signs and symptoms of odontogenic infections. “MY LAB-40” ultrasound machine with linear array transducer of 7.5 MHZ frequency was used for detecting cervical lymph nodes following Hajek’s classification. The patients further underwent ultrasound guided FNAC under standard aseptic protocol and samples were subjected to cytopathological evaluation. Chi square analysis and one way ANOVA test were applied to obtain the results. We concluded that ultrasound and USG FNAC can be used accurately to assess the status of lymph nodes. The ultrasonographic features of lymph nodes with round shape, absence of hilar echo, sharp nodal borders, hyperechoic internal echogenicity, and presence of intranodal necrosis were highly suggestive of metastatic cervical lymph nodes.


2006 ◽  
Vol 121 (4) ◽  
pp. 362-368 ◽  
Author(s):  
K Menon ◽  
C Bem ◽  
D Gouldesbrough ◽  
D R Strachan

Aims: To analyse the epidemiology, presentation and diagnosis of head and neck tuberculosis (TB).Methods: We conducted a 10-year retrospective study of all cases of tuberculosis of the head and neck region occurring in Bradford, UK.Results: Of a total of 1315 cases of TB, 128 presented with head and neck TB (12 per cent of which (15/128) were in children). Cervical lymph nodes were most commonly involved (87 per cent, 111/128), other sites being: salivary glands (five cases); larynx, oral cavity, eyes and ears (two cases each); and skin, thyroid, nasopharynx and retropharyngeal space (one case each). Patients' ethnic origins were Asian (89 per cent, 114/128), Caucasian (10 per cent, 13/128) and African (one case). Only 26 per cent (33/128) had constitutional symptoms, and 20 per cent (25/128) had a coexistent site of TB. Only 39 per cent (40/105) of surgical specimens were sent for culture.Conclusions: Isolated head and neck TB is not uncommon. Atypical presentations render diagnosis challenging, so awareness aids early diagnosis. Mycobacterial cultures should be performed, where possible, for diagnosis.


1997 ◽  
Vol 38 (5) ◽  
pp. 810-814 ◽  
Author(s):  
T. Yucel ◽  
I. Saatci ◽  
L. Sennaroglu ◽  
S. Cekirge ◽  
U. Aydingoz ◽  
...  

Purpose: To assess the efficacy of MR imaging in the detection of lymph node metastasis in patients with no palpable lymph nodes (“N0 neck”) who have squamous cell carcinoma of the head and neck region. Material and Methods: MR neck imagings in 18 patients who underwent neck dissection (bilaterally in 2) for squamous cell carcinoma of the head and neck region were examined preoperatively for the purpose of detecting lymph node metastases. The imaging features taken into consideration were: size (cutoff point 10 mm), grouping, presence of central necrosis, and appearance of extracapsular spread. The MR examinations comprised spin-echo T1- and T2-weighted sequences. The MR findings were compared with those of surgery and histopathological examination. Results:) MR suggested metastatic lymph node involvement in 5 necks. In 2 of these, central necrosis was seen in the enlarged lymph nodes. In a third, a grouping of the lymph nodes was noted. Extracapsular spread was not present. Histopathological examination revealed metastatic lymph nodes in 7 of the 20 necks, the rate of clinically occult disease being 35%, and 4 of them had been accurately graded by MR. There was one false-positive MR examination. The MR sensitivity was 57.1% and specificity 92.3%. Conclusion: MR may reveal metastatic lymph nodes in patients with no clinical evidence of metastasis. However, conventional MR techniques are not always sufficient for decision-making on surgery in cases of “N0 neck”).


2017 ◽  
Vol 59 (6) ◽  
pp. 672-680 ◽  
Author(s):  
Yan-Jun Wang ◽  
Xiao-Quan Xu ◽  
Hao Hu ◽  
Guo-Yi Su ◽  
Jie Shen ◽  
...  

Background To clarify the nature of cervical malignant lymphadenopathy is highly important for the diagnosis and differential diagnosis of head and neck tumors. Purpose To investigate the role of first-order apparent diffusion coefficient (ADC) histogram analysis for differentiating lymphoma from metastatic lymph nodes of squamous cell carcinoma (SCC) in the head and neck region. Material and Methods Diffusion-weighted imaging (DWI) data of 67 patients (lymphoma, n = 20; SCC, n = 47) with malignant lymphadenopathy were retrospectively analyzed. The SCC group was divided into nasopharyngeal SCC and non-nasopharyngeal SCC groups. The ADC histogram features (ADC10, ADC25, ADCmean, ADCmedian, ADC75, ADC90, skewness, and kurtosis) were derived and then compared by independent-samples t-test and one-way analysis of variance test, respectively. Receiver operating characteristic curve analyses were employed to investigate diagnostic performance of the significant parameters. Results Lymphoma showed significantly lower ADCmean, ADCmedian, ADC75, and ADC90 than SCC (all P < 0.05). Setting ADC90 = 0.719 × 10–3 mm2/s as the threshold value, optimal diagnostic performance was achieved (area under the curve [AUC] = 0.719, sensitivity = 95.7%, specificity = 50.0%). Subgroup analyses showed no significant difference between lymphoma and NPC (all P > 0.05). Lymphoma showed significantly lower ADC25, ADCmean, ADCmedian, ADC75, and ADC90 than non-nasopharyngeal SCC (all P < 0.05). Optimal diagnostic performance (AUC = 0.847, sensitivity = 86.7%, specificity = 80.0%) could be achieved when setting ADC90 = 0.943 × 10–3 mm2/s as the threshold value. Conclusion Given its limitations, our study has shown that first-order ADC histogram analysis is capable of differentiating lymphoma from metastatic lymph nodes of SCC, especially those of non-nasopharyngeal SCC.


2021 ◽  
Vol 6 (2) ◽  
pp. 91-96
Author(s):  
Jyoti P Sapre ◽  
Kirti N Vyas ◽  
Alpeshkumar M Maru

Swellings in the Head and Neck region are very common and are evaluated with the help of a detailed clinical history, physical examination and investigations like FNAC, USG, CT scan or excisional biopsy. Fine Needle Aspiration Cytology (FNAC) is a simple, quick, inexpensive and minimally invasive OPD procedure used in the diagnosis of different swellings of Lymph nodes, thyroid, salivary gland and soft tissues in the Head and Neck region.We did this study with the purpose of identifying the frequency and distribution of different pathologies found in FNAC done in patients presenting with a swelling in the Head and Neck region as per the site, age, sex and type of the lesion.A retrospective study was conducted on the patients presenting with swelling in the Head and Neck region at the Pathology department of a tertiary care hospital between the duration of 1 August 2019 to 30 April 2021. FNAC was performed on total 260 patients.Out of 260 cases, 157 cases (60.4%) were from Lymph nodes, 50 cases (19.2%) from thyroid gland, 27 cases (10.3%) from skin and subcutaneous tissue, 23 cases (8.84%) from salivary gland and 3 cases (1.1%) were inconclusive due to inadequate material aspiration. 149 cases (57.98%) were inflammatory, 70 cases (27.24%) benign and 38 cases (14.78%) were found to be malignant.FNAC is a simple, quick, inexpensive, minimally invasive OPD procedure and used as first line of investigation in the diagnosis of swellings in the Head and Neck region.


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