Distribution characteristic of nasopharyngeal and cervical lymph nodes metastasized from nasopharyngeal carcinoma on magnetic resonance imaging
Main Article Content
Abstract
Cervical lymphadenopathy is common in nasopharyngeal carcinoma (NPC). Magnetic Resonance Imaging (MRI) can precisely determine the site, size and gross morphology of retropharyngeal lymph nodes (RLNs). The MR images of 64 patients with newly diagnosed NPC at Ho Chi Minh City Oncology Hospital were reviewed retrospectively from August 2017 to December 2020. All the patients were scanned by 1.5T MRI systems. Metastatic RLNs were detected in nearly half of patients with NPC (48.15%). 78.79% of patients were found with RLNs distributed mainly at the level of the oropharynx. Level II lymph nodes maybe were the first echelons of nodal metastases (88.9% of patients had level II lymph nodes, followed by level III (55,6%) and cervical lymphadenopathy (48,1%) when cervical lymph node metastasis was present. There was a significant difference in the incidence of involvement of RLNs when the primary tumour extended into the nasal cavity, skull base, and sphenoid sinus (p < 0.05). There was no significant association between RLNs involvement and T1, T2, T3, and T4 (p = 0.766). There was a significant difference in the association between RLNs involvement and N1, N2, and N3 (p = 0.028).
Article Details
Keywords
Magnetic resonance imaging, nasopharyngeal carcinoma, retropharyngeal lymph node, cervical lymph node
References
2. Vincent Grégoire, Kian Ang, Wilfried Budach, et al. Delineation of the neck node levels for head and neck tumors: A 2013 update. DAHANCA, EORTC, HKNPCSG, NCIC CTG, NCRI, RTOG, TROG consensus guidelines. Radiotherapy and Oncology. 2014;10(10):1-20.
3. Laura B. Eisenmenger, Richard H Wiggins. Imaging of Head and Neck Lymph Nodes. Radiol Clin N Am. 2015;53:115-132.
4. Anne W.M. Lee, William M. Lydiatt, A. Dimitrios Colevas, et al. Nasopharynx. In: Mahul B. Amin, Stephen B. Edge, Robert K. Brookland, et al., eds. AJCC Cancer Staging Manual. 8th Ed. Springer. 2017:103-110.
5. Xiao Shen Wang, Chao Su Hu, Hong Mei Ying, et al. Patterns of retropharyngeal node metastasis in nasopharyngeal carcinoma. Int. J. Radiation Oncology Biol. Phys.. 2009;73(1):194–201.
6. Đoàn Trung Hiếu. Nghiên cứu đặc điểm lâm sàng, mô bệnh học của hạch cổ di căn trong ung thư vòm mũi họng. Trường Đại học Y Hà Nội. 2011.
7. Li-Zhi Liu, Guo-Yi Zhang, Chuang-Miao Xie, et al. Magnetic Resonance Imaging of retropharyngeal lymph node metastasis in Nasopharyngeal Carcinoma: Patterns of Spread. Int. J. Radiation Oncology Biol. Phys.. 2006;66(3):721–730.
8. Ann D. King, Anil T. Ahuja, Sing-fai Leung, et al. Neck node metastases from nasopharyngeal carcinoma: MR Imaging of patterns of disease. Head & Neck. 2000;275-281.
9. Shu-Hang Ng, Joseph Tung-Chieh Chang, Sheng-Chieh Chan, et al. Nodal metastases of nasopharyngeal carcinoma: Patterns of disease on MRI and FDG PET. Eur J Nucl Med Mol Imaging. 2004;31:1073–1080.
10. Chong VF, Y F Fan, J B Khoo. Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Eur J Radiol. 1995; 21:100-105.
11. Manas Sharma, Eric Bartlett, Eugene Yu. Metastatic retropharyngeal lymph nodes in nasopharyngeal carcinoma: imaging criteria. Expert Rev. Anticancer Ther. 2010;10(11):1703-1706.
12. Linglong Tang, Li Li, Yanping Mao, et al. Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma Detected by Magnetic Resonance Imaging - Prognostic Value and Staging Categories. American Cancer Society. 2008;113(2):347-354.