Radiologic-Pathologic Correlation of Unusual Lingual Masses:Part I: Congenital Lesions

Because the tongue is superficially located and the intial manifestation of most diseases occurring there is mucosal change, lingual these lesions can be easily accessed and diagnosed without imaging analysis. Most congenital lesions of the tongue, however, can manifest as a submucosal bulge and be located in a deep portion of that organ such as its base; their true characteristics and extent may be recognized only on cross-sectional images such as those obtained by CT or MRI. In addition, because it is usually difficult to differentiate congenital lesions from other submucosal neoplasms on the basis of imaging findings alone, clinical history and physical examination should always be taken into consideration when interpretating CT and MR images of the tongue. Although the radiologic findings for congenital lesions are nonspecific, CT and MR imaging can play an important role in the diagnostic work-up of these unusual lesions. Delineation of the extent of the tumor, and recognition and understanding of the spectrum of imaging and the pathologic features of these lesions, often help narrow the differential diagnosis.

Radiologic-Pathologic Correlation of Unusual Lingual Masses:Part II: Benign and Malignant Tumors

Because the tongue is superficially located and the initial manifestation of most diseases occurring there is mucosal change, lingual lesionscan be easily accessed and diagnosed without imaging analysis. Some lingual neoplasms, however, may manifest as a submucosal bulge and be located in a deep portion of the tongue, such as its base; their true characteristics and extent may be rec-ognized only on cross-sectional images such as those obtained by CT or MRI. Some uncommon tongue neoplasms may have characteristic radiologic fea-tures, thus permitting quite specific radiologic diagnosis. Lipomas typically manifest at both CT and MR imaging as homogeneous nonenhancing lesions. Relative to subcutaneous fat they are isoattenuating on CT images, and all MR sequences show them as isointense. Due to the paramagnetic properties of melanin, metastases from melanotic melanoma usually demonstrate high signal intensity on T1-weighted MR images and low signal intensity on T2-weighted images. Although the radiologic findings for other submucosal neoplasms are nonspecific, CT and MR imaging can play an important role in the diagnostic work-up of these unusual tumors. Delineation of the extent of the tumor, and recognition and understanding of the spectrum of imaging and the pathologic features of these lesions, often help narrow the differential diagnosis.