Skip to main content
SpringerLink
Log in

MRI findings of extranodal malignant lymphoma and squamous cell carcinoma in the head and neck regions

  • Original Article
  • Published:
Oral Radiology Aims and scope Submit manuscript

Abstract

Objectives

To compare magnetic resonance imaging (MRI) findings between patients with malignant lymphoma (ML) and squamous cell carcinoma (SCC) in the head and neck regions, and to show the characteristic findings for ML.

Methods

We analyzed 10 lesions in nine patients with ML and 25 lesions in 25 patients with SCC. Diffusion-weighted imaging, T1-weighted imaging, and T2-weighted imaging were performed for all lesions. We estimated the apparent diffusion coefficients (ADCs) with b-factors of 0, 500, and 1000 s/mm2, and obtained the means and standard deviations. In 29 cases, dynamic contrast-enhanced MRI (DCE-MRI) was performed and time–intensity curves were obtained. The peak time, maximum-to-initial ratio (MI ratio), end-to-maximum ratio, and end-to-initial ratio (EI ratio) were estimated. Receiver-operating characteristic analyses were performed to estimate the diagnostic power for these indices.

Results

The mean ADC for ML (0.762 ± 0.126 × 10−3 mm2/s) was significantly lower than that for SCC (1.24 ± 0.22 × 10−3 mm2/s, p < 0.0001). ML had a smaller MI ratio (2.13 ± 0.26) and smaller EI ratio (1.90 ± 0.29) than SCC (MI ratio: 2.46 ± 0.38, p = 0.033; EI ratio: 2.19 ± 0.29, p = 0.025). The area under the curve for the mean ADC (0.989) was higher than those for the MI ratio (0.779) and EI ratio (0.792).

Conclusions

The most characteristic findings for ML were extremely low ADCs. If the ADCs cannot be estimated because of severe susceptibility artifacts, DCE-MRI provides an alternative index for differentiating ML from SCC.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Barnes L, Eveson JW, Reichart P, Sidransky D. Pathology and genetics of head and neck tumours. Lyon: ARC Press; 2005.

    Google Scholar 

  2. Kemp S, Gallagher G, Kabani S, Noonan V, O’Hara C. Oral non-Hodgkin’s lymphoma: review of the literature and World Health Organization classification with reference to 40 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105:194–201.

    Article  PubMed  Google Scholar 

  3. Triantafillidou K, Dimitrakopoulos J, Iordanidis F, Gkagkalis A. Extranodal non-hodgkin lymphomas of the oral cavity and maxillofacial region: a clinical study of 58 cases and review of the literature. J Oral Maxillofac Surg. 2012;70:2776–85.

    Article  PubMed  Google Scholar 

  4. Yasumoto M, Shibuya H, Fukuda H, Takeda M, Mukai T, Korenaga T. Malignant lymphoma of the gingiva: MR evaluation. AJNR Am J Neuroradiol. 1998;19:723–7.

    PubMed  Google Scholar 

  5. Asaumi J, Yanagi Y, Hisatomi M, Matsuzaki H, Konouchi H, Kishi K. The value of dynamic contrast-enhanced MRI in diagnosis of malignant lymphoma of the head and neck. Eur J Radiol. 2003;48:183–7.

    Article  PubMed  Google Scholar 

  6. Asaumi J, Yanagi Y, Konouchi H, Hisatomi M, Matsuzaki H, Kishi K. Application of dynamic contrast-enhanced MRI to differentiate malignant lymphoma from squamous cell carcinoma in the head and neck. Oral Oncol. 2004;40:579–84.

    Article  PubMed  Google Scholar 

  7. Kitamoto E, Chikui T, Kawano S, Ohga M, Kobayashi K, Matsuo Y, et al. The application of dynamic contrast-enhanced MRI and diffusion-weighted MRI in patients with maxillofacial tumors. Acad Radiol. 2015;22:210–6.

    Article  PubMed  Google Scholar 

  8. Yabuuchi H, Fukuya T, Tajima T, Hachitanda Y, Tomita K, Koga M. Salivary gland tumors: diagnostic value of gadolinium-enhanced dynamic MR imaging with histopathologic correlation. Radiology. 2003;226:345–54.

    Article  PubMed  Google Scholar 

  9. Matsuzaki H, Yanagi Y, Hara M, Katase N, Hisatomi M, Unetsubo T, et al. Diagnostic value of dynamic contrast-enhanced MRI for submucosal palatal tumors. Eur J Radiol. 2012;81:3306–12.

    Article  PubMed  Google Scholar 

  10. Hisatomi M, Asaumi J, Yanagi Y, Unetsubo T, Maki Y, Murakami J, et al. Diagnostic value of dynamic contrast-enhanced MRI in the salivary gland tumors. Oral Oncol. 2007;43:940–7.

    Article  PubMed  Google Scholar 

  11. Tofts PS, Brix G, Buckley DL, Evelhoch JL, Henderson E, Knopp MV, et al. Estimating kinetic parameters from dynamic contrast-enhanced T (1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging. 1999;10:223–32.

    Article  PubMed  Google Scholar 

  12. Wang J, Takashima S, Takayama F, Kawakami S, Saito A, Matsushita T, et al. Head and neck lesions: characterization with diffusion-weighted echo-planar MR imaging. Radiology. 2001;220:621–30.

    Article  PubMed  Google Scholar 

  13. Fong D, Bhatia KS, Yeung D, King AD. Diagnostic accuracy of diffusion-weighted MR imaging for nasopharyngeal carcinoma, head and neck lymphoma and squamous cell carcinoma at the primary site. Oral Oncol. 2010;46:603–6.

    Article  PubMed  Google Scholar 

  14. Maeda M, Kato H, Sakuma H, Maier SE, Takeda K. Usefulness of the apparent diffusion coefficient in line scan diffusion-weighted imaging for distinguishing between squamous cell carcinomas and malignant lymphomas of the head and neck. AJNR Am J Neuroradiol. 2005;26:1186–92.

    PubMed  Google Scholar 

  15. Ichikawa Y, Sumi M, Sasaki M, Sumi T, Nakamura T. Efficacy of diffusion-weighted imaging for the differentiation between lymphomas and carcinomas of the nasopharynx and oropharynx: correlations of apparent diffusion coefficients and histologic features. AJNR Am J Neuroradiol. 2012;33:761–6.

    Article  PubMed  Google Scholar 

  16. Sumi M, Ichikawa Y, Nakamura T. Diagnostic ability of apparent diffusion coefficients for lymphomas and carcinomas in the pharynx. Eur Radiol. 2007;17:2631–7.

    Article  PubMed  Google Scholar 

  17. Matsumoto S, Shibuya H, Tatera S, Yamazaki E, Suzuki S. Comparison of CT findings in non-Hodgkin lymphoma and squamous cell carcinoma of the maxillary sinus. Acta Radiol. 1992;33:523–7.

    Article  PubMed  Google Scholar 

  18. Urquhart AC, Hutchins LG, Berg RL. Distinguishing non-Hodgkin lymphoma from squamous cell carcinoma tumors of the head and neck by computed tomography parameters. Laryngoscope. 2002;112:1079–83.

    Article  PubMed  Google Scholar 

  19. Wu X, Pertovaara H, Dastidar P, Vornanen M, Paavolainen L, Marjomäki V, et al. ADC measurements in diffuse large B-cell lymphoma and follicular lymphoma: a DWI and cellularity study. Eur J Radiol. 2013;82:e158–64.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Section of Image Diagnosis, Department of Diagnostics and General Care, Fukuoka Dental College, Tamura 2-15-1, Sawara-ku, Fukuoka, 814-0193, Japan

    Tomoko Shiraishi, Marie Hashimoto, Chika Horio, Toyohiro Kagawa, Kunihiro Miwa & Kenji Yuasa

  2. Department of Oral and Maxillofacial Radiology, School of Dental Science, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan

    Toru Chikui

  3. Department of Radiology, Fukuoka Dental College Medical and Dental Hospital, Tamura 2-15-1, Sawara-ku, Fukuoka, 814-0193, Japan

    Daisuke Inadomi

Authors
  1. Tomoko Shiraishi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Toru Chikui
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Daisuke Inadomi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marie Hashimoto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chika Horio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Toyohiro Kagawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kunihiro Miwa
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Kenji Yuasa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomoko Shiraishi.

Ethics declarations

Conflict of interest

Tomoko Shiraishi, Toru Chikui, Daisuke Inadomi, Marie Hashimoto, Chika Horio, Toyohiro Kagawa, Kunihiro Miwa, and Kenji Yuasa declare that they have no conflict of interest.

Human rights statements and informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (Fukuoka Dental College, Japan) and with the Declaration of Helsinki of 1964 and later versions. Because the patients were retrospectively recruited from our reporting system between October 2006 and July 2012, we could not obtain informed consent from the participants. The study plan was placed on a website and the patients had right of refusal for inclusion in this study. Our institutional ethics committee (Fukuoka Dental College) approved this retrospective study (approval number 244).

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shiraishi, T., Chikui, T., Inadomi, D. et al. MRI findings of extranodal malignant lymphoma and squamous cell carcinoma in the head and neck regions. Oral Radiol 32, 98–104 (2016). https://doi.org/10.1007/s11282-015-0219-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11282-015-0219-3

Keywords

Search

Navigation