Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma

Abstract

Background This study was done to investigate the size of normal retropharyngeal lymph nodes (RLN) and the incidence of retropharyngeal lymph node involvement in patients with nasopharyngyngeal carcinoma (NPC). Methods Forty‐four NPC patients who had not yet received treatment and 20 control subjects underwent MRI scanning. The number and the maximum diameter of the short axis of the cervical lymph nodes were measured. The number of nasopharyngeal walls involved and the maximum diameter of the tumor were recorded. Results In 5 of 20 control subjects lateral RLN were identified; none of these nodes was greater than 2.5 mm. In the NPC patients, taking 4 mm as the upper limit of normal RLN, 89% of the patients had enlarged RLN. The number of nasopharyngeal walls involved and the maximum diameter of the primary tumor showed no statistical relationship with the involvement of RLN. There was a statistical association between RLN and level II node involvement, but not with other groups of neck nodes. Conclusion Of all patients with NPC, 89% showed enlarged RLN. Its involvement was related to level II nodes but not to the number of nasopharyngeal sites involved nor with the maximum diameter of the tumor. © 1997 John Wiley & Sons, Inc. Head Neck 19: 176–181, 1997.

Retropharyngeal Lymph Node Metastasis in Nasopharyngeal Carcinoma: Prognostic Value and Staging Categories

“…These differences may be explained by a difference of RLN size criteria. A minimal axial diameter of z5 mm for metastatic RLNs was used as the size criteria in our study, based on the recommendation of published reports (3,4). In Chua et al's study, lymph nodes with a maximum dimension of z10 mm were used as the size criteria for RLN metastasis, and a decreased incidence (29.1%) of RLN metastasis was observed (9).…”

Comprehensive imaging of residual/recurrent nasopharyngeal carcinoma using whole-body MRI at 3 T compared with FDG-PET-CT

“…MRI was considered positive in the presence of focal areas of abnormal contrast enhancement, a mass or asymmetry at the primary site beyond that regarded as expected post-radiation changes. Lymph nodes were considered metastatic if their shortest axial diameter was ≥5 mm (in the retropharyngeal region) or ≥10 mm (in other regions), or if central necrosis was present [7,9,[28][29][30][31]. The probability of residual/recurrent tumours was graded by using a five-point scoring system (0 = no lesion, 1 = definitely benign, 2 = probably benign, 3 = probably malignant, 4 = definitely malignant).…”

The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma

“…15 The lateral RLN was considered metastatic if its shortest axial dimension was 5 mm, and any visible LN in the median retropharyngeal group was considered malignant. 16 The cervical LNs were considered metastatic if their shortest axial dimension was !11 mm in the jugulodigastric region, !10 mm in other cervical regions, or if there was a group of !3 LNs that were borderline in size. 15 The criterion for the diagnosis of central necrosis on MRI was a focal area of high signal intensity on T2-weighted images or a focal area of low signal intensity on T1-weighted images with or without a surrounding rim of enhancement 17 ; and the criterion for extracapsular spread was the presence of indistinct LN margins, irregular LN capsular enhancement, or infiltration into the adjacent fat or muscle.…”