Chulalongkorn Medical Journal


Background : Lymphoma is the second most common neoplasm in the headand neck. According to the recent study in Thailand, the incidenceof malignant lymphoma was increasing. The roles of CT wereassessment of known tumor, identification of occult tumor sites,assessment of treatment response, and recurrent tumor diagnosis.Objective : To describe and characterize CT findings of lymphoma of headand neck of Patients at King Chulalongkorn Memorial Hospital(KCMH).Design : Retrospective descriptive studySetting : Department of Radiology, King Chulalongkorn MemorialHospital (KCMH)Materials and Methods : We retrospectively reviewed nodal and extranodal findings onbaseline CT scan of 62 patients, who were newly diagnosedwith lymphoma of the head and neck by tissue pathology andunderwent pretreatment CT scan of the neck, orbit or paranasalsinuses in KCMH from January 1, 2006 to October 31, 2011.Results : Three patients had Hodgkin lymphoma (HL) and 59 Non-Hodgkinlymphomas (NHL). Forty six patients (74%) had primary lymphomaof the head and neck. The other 16 patients (26%) had systemiclymphoma that partly involved the head and neck. CTmanifestations in lymphoma of the head and neck varied; 24%were isolated nodal disease (type I CT pattern); 15% were isolatedextranodal lymphatic/extralymphatic disease (type II CT pattern);56% were combined nodal and extranodal lymphatic/extralymphatic diseases (type III CT pattern); and, 5% weremultifocal extranodal lymphatic/extralymphatic diseases (type IVCT pattern). Sites of extranodal involvement found in this studywere at Waldeyer’s ring (39%), orbital (32%), nasal cavities (13%),mandible (2%) and thyroid gland (2%). About 16% of the patientshad bone destruction.Conclusions : There were variable CT manifestations of lymphoma, from nodalto extranodal lymphatic to extranodal extra-lymphatic disease.NHL is much more common than HL and frequently presentswith combined nodal and extranodal diseases (either lymphaticor extralymphatic diseases). Frequently extranodal sites in thisstudy are Waldeyer’s ring, orbital and sinonasal cavities indescending order of frequency. There is HIV-associatedlymphoma, such as plasmablastic lymphoma of the mandible,that has unusual presence in patients with normal immune status.


Faculty of Medicine, Chulalongkorn University

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