头颈部非霍厅金淋巴瘤的CT表现

目的 评价头颈部非霍奇金淋巴瘤（ｎｏｎ－Ｈｏｄｇｋｉｎ ｌｙｍｐｈｏｍａ,ＮＨＬ）的ＣＴ表现特点,为临床诊疗提供可靠依据。方法 将３６例ＮＨＬ病灶分为颈淋巴结内线和淋巴结外组,并观察其ＣＴ形态、密度和边缘。结果 结外ＨＮＬ病 变共３９灶（３１例）,依次风于Ｗａｌｄｅｙｅｒ环（１１灶）、上颌８灶）、颌面间隙（７灶）、肋腺（６灶）和头颈其他部（７灶）。病变形态有肿块和粘膜异常增厚之分。结内ＮＨＬ病变共     

口腔颌面部恶性黑色素瘤的CT表现

目的：评价口腔颌面部恶性黑色素瘤的CT表现。方法：回顾性分析了经CT检查的口腔颌面颈恶性黑色素瘤病例15例(23灶)。CT检查包括平扫(15例,23灶)和增强(12例,19灶)。所有病例均经病理检查证实。结果：22/23灶恶性黑色素瘤在CT检查中呈阳性表现．包括原发病变14灶和颈部淋巴结转移性病变8灶。病变呈软组织肿块者20灶,黏膜增厚者2灶(均为原发灶)。病变边缘不清者18灶,边缘清晰者4灶。增强CT显示：不均匀强化者9灶,均匀强化者5灶,无强化者5灶。病变压迫颈静脉变形3灶,侵犯上颌骨7灶,侵犯下颌骨2灶。结论：口腔颌面部恶性黑色素瘤的CT表现具有多样性。病变多以边界不清并有增强的软组织肿块为特点。     

上颈部淋巴结恶性肿瘤影响颈鞘的CT评价

目的：评价上颈部淋巴结恶性肿瘤影响颈鞘的CT表现。方法：收集经手术和活检病理证实的上颈部淋巴结恶性肿瘤病例77例(83例病变),并对其在CT上显示的影响颈鞘及其内部血管的形式进行分类和评价。结果：CT上,病变对颈鞘及其内部血管影响的表现主要有：①颈鞘内血管受压变形者52例病变(颈内动脉1例;颈内静脉51例);②颈鞘内血管受压“消失”者13例病变(均为颈内静脉);③颈鞘内血管受压移位者67例(颈内动脉22例,颈内静脉50例);④淋巴结恶性肿瘤围绕颈鞘血管者15例。结论：上颈部淋巴结恶性肿瘤对颈鞘内部血管的影响主要表现为推移和受压变形。判断病变是否侵犯颈鞘及其内部血管,应综合考虑其CT影像表现。     

头颈部IgG4相关疾病CT影像学特点

目的 总结IgG4相关疾病头颈部CT影像学表现，分析其影像学特点，提高对该病的诊断水平。方法 回顾性研究2019年9月—2021年12月在山西医科大学第一医院口腔颌面外科诊治，并最终经组织病理学确诊的IgG4相关疾病患者的临床一般资料及CT资料，观察受累部位、病变特点等。结果 按照纳排标准共纳入20例患者，其中14例双侧颌下腺受累，6例单侧颌下腺受累，8例双侧腮腺受累，1例单侧腮腺受累，11例泪腺受累，3例甲状腺受累，此外笔者观察到95%(19例)患者头颈部受累腺体周围或颈部可见肿大淋巴结。CT影像中，唾液腺受累表现为腺体不同程度的弥散性肿大或腺体内存在实质性团块，在笔者收集的病例中，所有受累腺体的CT影像均未见明显钙化或囊性病变。泪腺受累多表现为双侧对称性肿大，密度均匀，部分患者可见眼外肌、眶下神经增粗受累。淋巴受累表现为单个或多个肿大淋巴结，边界清晰，无明显钙化及坏死液化影。甲状腺受累表现为腺体局部见低密度影像，形态不规则，与正常腺体边界欠佳。另外部分患者可观察到鼻旁腺、鼻腔黏膜及血管受累影像。结论 头颈部IgG4相关疾病在CT下具有一些体征性的表现，准确识别并判断这些CT表现有助...     

口腔结外型非何杰金氏淋巴瘤

<正>恶性淋巴瘤是全身性疾患,病变可发生于淋巴结(结内型)也可累及淋巴结外的组织器官(结外型),后者常发生于胃肠道、鼻咽部,扁桃体等部位,而发生于口腔内者较少见,且临床表现错综复杂,易被误诊.本文就我院诊治的口腔结外型非何杰金氏淋巴瘤(NHL)26例对其临床病理特征进行分析报道.     

腮腺少见肿瘤的增强CT表现及其病理基础

目的 探讨腮腺少见肿瘤增强CT表现特征与病理的相关性,以提高影像诊断水平。方法 对22例经手术病理证实的少见腮腺肿瘤进行回顾性分析,包括基底细胞瘤6例,肌细胞上皮瘤5例,脉管瘤4例,淋巴上皮囊肿及腮腺脂肪瘤各3例,软骨肉瘤1例。在增强CT图像上,从病变所在腮腺的位置、病变大小和形态、病变密度以及其与周围结构的关系进行总结分析。结果 基底细胞瘤发生在腮腺浅叶,边界清楚,病变内易囊变。增强扫描呈不均匀中度-明显强化肿块,边缘或内部可见结节状强化,可伴有增大的淋巴结。肌细胞上皮瘤多发于腮腺浅叶,易发生小囊变,少数病变内可有小点状钙化。实性部分增强后中度-明显强化,多有典型的动脉期强化结节和边缘显著强化。血管瘤为软组织肿块,病变较大可占据整个腮腺,密度均匀或不均匀,可见静脉石,突出于腮腺表面,增强后轻度-明显强化。淋巴上皮囊肿囊液较黏稠,CT值密度较高。软骨肉瘤以囊性为主的肿块,含边缘钙化、骨化成分的肿块。腮腺脂肪瘤可见脂肪密度肿块,边界清晰,无强化,病变内可见纤维分隔。结论 腮腺少见肿瘤的增强CT表现具有一定的影像学特征,可揭示其病理基础;增强CT是诊断腮腺少见肿瘤病变性质有效的影像检查手段。     

成年与未成年人下颌骨组织细胞增多症X之X线表现

作者将28例下颌骨组织细胞增多症分为未成年(19例,21灶)和成年人(9例,12灶)两组,分别对其X线表现异同进行了归类对比,结果提示;两组患者之x线表现因其生理、形态结构不同而确有差异,其中儿童、青少年之X线表现又具有一定特点:即边缘不规则的溶骨性破坏灶多伴有下颌骨下外缘的骨膜反应。成年人则囚较少这种表现而很难与其他下颌骨病变相区别。     

舌癌的CT诊断

目的：探讨舌癌的多层螺旋CT表现特征及诊断价值,评价CT检查在舌癌诊断中的应用价值。方法：回顾性分析经手术及病理证实的舌癌16例,其中男10例,女6例,年龄45-75岁,平均年龄51岁。16例均行CT平扫及增强CT扫描。对病变的部位、形状、密度及向周围浸润情况等几个方面进行回顾性分析。结果：16例病理类型均为鳞状细胞癌,舌体癌11例,舌根癌4例,全舌癌1例,14例伴有溃疡,侵犯肌层12例,侵犯口底4例,11例伴有颌下及颈部淋巴结多发转移。舌癌CT平扫表现为舌体及舌根边缘区稍低密度肿块13例,2例表现为等密度肿块,1例表现为稍高密度肿块,边界均模糊不清,内密度不均匀。CT增强扫描后肿块明显不均匀强化14例,环形强化2例,增强后肿块边界及轮廓显示清楚,呈分叶状,14例溃疡型肿块内见气体影,11例颌下及颈部间隙内可见多发肿大淋巴结,增强后明显不均匀强化。结论：CT检查对原发性舌癌的形态、大小、密度及周围结构侵犯以及颈部淋巴结转移等方面有重要的诊断价值,增强扫描对病灶显示尤为重要。     

29例头颈部炎性肌纤维母细胞肿瘤的CT及MRI影像学特征分析

目的: 探讨头颈部炎性肌纤维母细胞肿瘤 (inflammatory myofibroblastic tumor,IMT)的CT及MRI影像学特征,以提高该肿瘤的术前正确诊断。方法: 回顾性收集2012年1月——2018年12月上海交通大学医学院附属第九人民医院初诊并经术后病理检查证实的29例头颈部IMT患者,总结分析患者术前CT及MRI影像学表现。结果: 29例头颈部IMT患者中,67.0%（20/29）的患者术前被误诊为恶性肿瘤。头颈部IMT的影像学表现多样,局限性软组织内肿块7例,软组织肿块伴邻近骨质破坏12例（颞下窝5例,上颌窦6例,颌面部广泛软组织病变1例）,骨内肿块10例（上颌骨5例,下颌骨4例,颞骨1例）。89.7%（26/29）病灶边界不清楚;75.9%（22/29）病灶有骨质破坏,34.5%（10/29）病灶骨质破坏与骨质增生硬化并存。8例患者沿神经孔道侵犯邻近结构（6例发生于颞下窝,其中4例侵犯翼腭窝,沿圆孔、卵圆孔累及颅内,2例侵犯眶尖视神经管;2例发生于下颌骨,侵犯下颌神经管）。头颈部IMT在CT平扫时呈等或稍低密度, 未见钙化,增强扫描呈中度至明显强化。在MRI上,9例T1WI呈等或稍低信号;7例T2WI呈低信号;9例DWI呈高信号,ADC值约（0.6~1.0）×10^-3mm²/s。TIC曲线Ⅰ型7例,Ⅱ型2例。均未出现颈淋巴结及远处转移。结论: 头颈部IMT的影像学特征与恶性肿瘤相近,但骨质破坏的同时伴有骨质增生硬化,T2WI呈低信号,TIC曲线以Ⅰ型为主,极少发生颈淋巴结及远处转移。结合CT、MRI及功能学检查,可在一定程度上反映病灶的组织构成,为术前正确诊断提供重要依据。     

双能量CT在颈部淋巴结病变评估中的研究进展

头颈部淋巴结病变的早期发现及定性诊断至关重要,有助于临床及时采取干预措施及制定治疗方案,延缓或终止疾病进展。目前双能量CT的多组图像,如虚拟平扫图像、碘图、虚拟单能量图像、光谱亨斯菲尔德单位衰减曲线及混合图像等已逐步用于评估头颈部淋巴结病变,为淋巴结病变的定性、分期及病理分型提供了诸多量化指标。本文就双能量CT的多组后处理图像及相关参数在颈部淋巴结病变评估中的研究进展作一综述。     

Primary extranodal lymphoma of the maxilla: a case report with imaging features and dynamic data analysis of magnetic resonance imaging

Malignant lymphoma is the second-most common malignancy in the head and neck region. Waldeyer's ring is the most common site of extranodal Hodgkin's lymphoma (NHL) in that region, and a small percentage of primary extranodal NHL occurs in the oral cavity. The most common sites of extranodal NHL in the oral region are the palate and maxilla, and nearly half of extranodal NHL cases arise from bone. It is difficult to diagnose extranodal NHL because of the variety of its radiological features. We report a case of primary extranodal NHL of the maxilla in a 68-year-old female patient with atypical imaging findings, along with the results of analysis of dynamic magnetic resonance imaging (MRI).     

Non-Hodgkin lymphoma of the mandible--a case report with differential diagnostic considerations

Approximately 5% of all malignant lesions are diagnosed as malignant lymphomas, of which 2-3% are localized in the head and neck region. After the squamous cell carcinoma and neoplasms of the salivary glands, malignant lymphomas represent the third most frequent malignant lesion in that region. Malignant lymphomas can be grouped into Hodgkin- and non- Hodgkin lymphomas (NHL) and subdivided into nodal (lymph nodes) and extranodal lymphomas. We present the case of an extranodal non-Hodgkin lymphoma in the left mandible of a 47-year-old woman, who was referred to our department with an unclear swelling, which was supposed to be infectious. After clinical and radiological examination, a biopsy was taken and a CD20 and BCL-6 protein positive non-Hodgkin lymphoma of the large B-cell type (DLBCL) was diagnosed. The patient was treated primarily with immunochemotherapy (R-CHOP protocol) and refused to undergo a subsequent radiotherapy. The 18 months follow-up showed a complete remission of the lymphoma. In this paper, the NHL in the oral and maxillofacial region is presented as a cause of unclear swelling. Important differential diagnostic conditions are discussed.     

Head and neck non-Hodgkin's lymphoma: a 20-year demographic study of 381 cases

Malignant lymphoma is a lymphoreticular malignancy with considerable geographic variation. The objective of the present study was to provide a preliminary report on patients with head and neck non-Hodgkin's lymphoma (NHL) in a selected Iranian population. In a retrospective review from 1981 through 2001, all cases of NHL occurring in the head and neck region were selected. Histological slides were reviewed and classified according to the Working Formulation. Clinical data including patients’ age, sex, initial anatomic site of disease and presenting symptoms were also recorded. Information on 381 cases of NHL was retrieved from the archived medical records; 281 cases were nodal and 100 extranodal. The mean age of the patients with nodal and extranodal disease was 39.3 and 47.7 years, respectively. A significant difference in gender was noted in the nodal group (P < 0.001), but not in the extranodal cases. The most common site of involvement in the extranodal subjects was Waldayer's ring. According to histopathologic evaluation, 72% of the specimens were intermediate-, 14% were high-, and 12% were low-grade malignancies. Considering the relative frequency of head and neck lymphoma, establishment of a uniform reporting method seems necessary in order to compare different reports from various populations.     

Rosai-Dorfman disease of the mandible

Rosai-Dorfman disease (RDD) is a rare, non-neoplastic histiocytosis most commonly characterized by painless, massive cervical lymphadenopathy. Over half of all patients with lymph node involvement also demonstrate extranodal disease, with most affected individuals exhibiting lesions within the region of the head and neck. Oral manifestations of RDD are extremely rare, and almost always identified in association with nodal or other extranodal disease. However, rare examples of extranodal RDD, including oral RDD, without clinical or radiographic evidence of concomitant lymph node involvement, have also been described. We report a rare case of solitary, extranodal RDD arising within the mandible in a pregnant woman. To our knowledge, this case represents only the fourth documented example of solitary oral RDD. A review of the clinical and histopathologic features associated with RDD is also presented.     

Extranodal non-Hodgkin's lymphoma of the maxillofacial region: analysis of 88 consecutive cases.

Examination of the records of 88 consecutive patients with extranodal maxillofacial non-Hodgkin's lymphoma (ENHL) was undertaken. Each patient's complete record was reviewed. Males outnumbered females by 1.7:1. Age at diagnosis ranged from 22 to 94 years (median 60.0). Affected anatomic sites included: maxillary sinus (22), nasal cavity (8), maxilla (13), mandible (8), salivary glands (14), and other (23). The most common presenting symptom was a non-painful mass. Associated dental symptoms were present in 72 patients and included intraoral swelling, pain, and loose teeth. Treatment included chemotherapy and radiation with a follow-up of 1-25 years. Treatment trends indicate a shift towards multimodal therapy. Non-Hodgkin's lymphoma of the head and neck, if discovered early, has an excellent prognosis.     

CT findings of cervical lymph node metastasis from intraoral mucoepidermoid carcinoma: Histopathological correlation

Objectives To evaluate CT findings of metastatic cervical nodes from intraoral mucoepidermoid carcinoma and to correlate them with histopathological findings. Methods Five metastatic cervical lymph nodes in four patients with intraoral mucoepidermoid carcinoma were included in this study. The primary sites of the tumors were the palate (n=2), the lower gingiva (n=1) and the tongue (n=1). The findings for these nodes on contrast-enhanced CT images were retrospectively evaluated and compared with the histopathological findings. Results Among the five metastatic nodes, the minimal axial diameter ranged from 12 mm to 19 mm. They all contained low-density areas on CT, suspicious for nodal necrosis, and showed heterogeneous or rim enhancement. Histopathologically, they all had intranodal cysts, which were consistent with the low-density areas detected on CT. Conclusion The CT findings of cervical metastases from intraoral mucoepidermoid carcinoma were characterized by the presence of low-density areas within the nodes. Although these findings suggested nodal necrosis typically seen in squamous cell carcinoma, they were histopathologically confirmed to reflect intranodal cyst formation.     

Orofacial non-Hodgkins lymphoma in Nigerians.

PURPOSE: In this study, we sought to determine the occurrence of primary non-Hodgkins lymphoma (NHL) in the oral and maxillofacial region among Nigerians. PATIENTS AND METHODS: We retrospectively studied hospital records that included radiographs of all patients with a histopathologically confirmed diagnosis of NHL in the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria, between January 1992 and December 1997. Data were expressed as mean +/- SD or number (%). RESULTS: During the study period, 66 cases of NHL were recorded. Seventeen patients had concomitant extranodal lymphomas involving the gastrointestinal tract, nasopharynx, skin, lungs, kidney, and thyroid, in descending order. Three patients (4.5%) presented primarily with extranodal oral and maxillofacial disease. The ages of these patients ranged from 18 to 50 years (mean +/- SD, 32.3 +/- 16.3 years; median, 29 years). Within the same period, there were 121 cases of Burkitts lymphoma. The onset of lesions varied from 6 to 20 weeks. Two patients had intermediate-grade lesions; the remainder had low-grade lesions. Two presented with stage II disease, and the remainder were stage I. All of the patients had chemotherapy with remission of their lesions but were followed up to 6 months. Most of them did not complete the treatment cycles due to financial and social constraints. CONCLUSIONS: The rarity of primary NHL of oral and maxillofacial region has been aptly shown in this study. The need for the establishment of an effective oncology policy with the active collaboration of voluntary agencies is emphasized. This would ensure ready availability of the required chemotherapeutic agents and hospital care at affordable costs.