CT of head and neck lymphoma

ABSTRACT

Lymphoma is the second most common neoplasm in the head and neck, and is the most common cause of unilateral neck mass in patients between 21 and 40 years of age. This report is a retrospective review of histologically proven lymphomas in 42 patients regarding histologic type, clinical stage, and CT imaging patterns. CT imaging plays an important role in making diagnosis, planning treatment, and evaluating recurrence after treatment. CT imaging patterns are classified into 4 types Type 1 is nodal lymphoma, Type 2 extranodal lymphoma, Type 3 combined nodal and extranodal lymphoma, and Type 4 multifocal extranodal lymphoma. In conclusion, Lymphoma should be considered when multiple, nonnecrotic, homogenous lymph nodes are located in deep lymphatic chains (especially when they are large and bilateral or when both are the superficial and deep lymph node chains are involved simultaneously) and no mucosal abnormality of the aerodigestive tract is observed. Additionary, when a large nasopharyngeal mass lesion shows limited or equivocal bone destruction or a mass is identified on two sides of a nasal bone without frank destruction and when multiple sites of disease are identified in extranodal tissues.