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Value of contrast-enhanced MRI in the differentiation between nasopharyngeal lymphoid hyperplasia and T1 stage nasopharyngeal carcinoma

  • HEAD, NECK AND DENTAL RADIOLOGY
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Abstract

Objectives

To investigate the value of contrast-enhanced MRI in differentiation between benign nasopharyngeal lymphoid hyperplasia (NPLH) and T1 stage nasopharyngeal carcinoma (NPC).

Methods

Eighty-six NPLH patients and 38 T1 stage NPC patients who underwent a contrast-enhanced MRI and an endoscopic biopsy were included. The patients’ symptoms and MRI features of nasopharyngeal mucosal thickening like location, symmetry, nasopharyngeal bubble, superficial mucus, nasopharyngeal retention cysts, serrated protrusions, contrast-enhancement type were documented. Accompanying signs such as sinus mucosal thickening, middle ear effusion, and cervical lymph nodes enlargement were also recorded. These MRI features were compared by Chi-square tests. Logistic regression analysis was done to identify the most predictive MRI features of malignancy.

Results

NPLH patients had more symptoms of pharynx discomfort or pain, while T1 stage NPC patients had more symptom of neck mass (P < 0.05). The most common pattern of nasopharyngeal mucosal thickening in NPLH was diffuse wall thickening (38.37%), while unilateral posterolateral wall thickening (39.47%) was more in T1 stage NPC. Nasopharyngeal bubble, retention cysts, serrated protrusions, symmetry, homogeneous enhancement, slight enhancement and vertical stripes were more common in NPLH, while nasopharyngeal wall asymmetry, inhomogeneous enhancement, moderated or marked enhancement and cervical lymph nodes enlargement were more in T1 stage NPC (P < 0.05). Logistic regression analysis identified unilateral posterolateral wall thickening, nasopharyngeal wall asymmetry, inhomogeneous enhancement and cervical lymph nodes enlargement were the most predictive MRI features for malignancy.

Conclusions

Careful analysis of contrast-enhanced MRI features of the nasopharynx and neck is helpful in differentiating benign NPLH from T1 stage NPC.

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Abbreviations

NPLH:

Nasopharyngeal lymphoid hyperplasia

NPC:

Nasopharyngeal carcinoma

MRI:

Magnetic resonance imaging

References

  1. King AD, Vlantis AC, Tsang RK, Gary TM, Au AK, Chan CY, Kok SY, Kwok WT, Lui HK, Ahuja AT (2006) Magnetic resonance imaging for the detection of nasopharyngeal carcinoma. AJNR Am J Neuroradiol 27(6):1288–1291

    CAS  PubMed  Google Scholar 

  2. Kamel RH, Ishak EA (1990) Enlarged adenoid and adenoidectomy in adults: endoscopic approach and histopathological study. J Laryngol Otol 104(12):965–967

    Article  CAS  PubMed  Google Scholar 

  3. Finkelstein Y, Malik Z, Kopolovic J, Bernheim J, Djaldetti M, Ophir D (1997) Characterization of smoking-induced nasopharyngeal lymphoid hyperplasia. Laryngoscope 107(12 Pt 1):1635–1642

    Article  CAS  PubMed  Google Scholar 

  4. Chan AT, Felip E (2009) Nasopharyngeal cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol Off J Eur Soc Med Oncol ESMO 20(Suppl 4):123–125. doi:10.1093/annonc/mdp150

    Google Scholar 

  5. King AD, Vlantis AC, Bhatia KS, Zee BC, Woo JK, Tse GM, Chan AT, Ahuja AT (2011) Primary nasopharyngeal carcinoma: diagnostic accuracy of MR imaging versus that of endoscopy and endoscopic biopsy. Radiology 258(2):531–537. doi:10.1148/radiol.10101241

    Article  PubMed  Google Scholar 

  6. Bhatia KS, King AD, Vlantis AC, Ahuja AT, Tse GM (2012) Nasopharyngeal mucosa and adenoids: appearance at MR imaging. Radiology 263(2):437–443. doi:10.1148/radiol.12111349

    Article  PubMed  Google Scholar 

  7. King AD, Vlantis AC, Yuen TW, Law BK (2015) Detection of nasopharyngeal carcinoma by MR imaging: diagnostic accuracy of MRI compared with endoscopy and endoscopic biopsy based on long-term follow-up. Am J Neuroradiol 36(12):2380–2385. doi:10.3174/ajnr.A4456

    Article  CAS  PubMed  Google Scholar 

  8. Surov A, Ryl I, Bartel-Friedrich S, Wienke A, Kosling S (2015) Diffusion weighted imaging of nasopharyngeal adenoid hypertrophy. Acta Radiol (Stockholm, Sweden: 1987) 56(5):587–591. doi:10.1177/0284185114534107

  9. Liu XW, Xie CM, Mo YX, Zhang R, Li H, Huang ZL, Geng ZJ, Zheng L, Lv YC, Wu PH (2012) Magnetic resonance imaging features of nasopharyngeal carcinoma and nasopharyngeal non-Hodgkin’s lymphoma: are there differences? Eur J Radiol 81(6):1146–1154. doi:10.1016/j.ejrad.2011.03.066

    Article  PubMed  Google Scholar 

  10. Wee JT, Ha TC, Loong SL, Qian CN (2010) Is nasopharyngeal cancer really a “Cantonese cancer”? Chin J Cancer 29(5):517–526

    Article  CAS  PubMed  Google Scholar 

  11. Loh LE, Chee TS, John AB (1991) The anatomy of the Fossa of Rosenmuller–its possible influence on the detection of occult nasopharyngeal carcinoma. Singapore Med J 32(3):154–155

    CAS  PubMed  Google Scholar 

  12. Woodfield CA, Levine MS, Rubesin SE, Laufer I, Mirza N (2005) Pharyngeal retention cysts: radiographic findings in seven patients. AJR Am J Roentgenol 184(3):793–796. doi:10.2214/ajr.184.3.01840793

    Article  PubMed  Google Scholar 

  13. King AD, Kew J, Tong M, Leung SF, Lam WW, Metreweli C, van Hasselt CA (1999) Magnetic resonance imaging of the eustachian tube in nasopharyngeal carcinoma: correlation of patterns of spread with middle ear effusion. Am J Otol 20(1):69–73

    CAS  PubMed  Google Scholar 

  14. Jordan RE (1955) Nasopharyngeal lymphoid tissue and its relationship to hearing. AMA Arch Otolaryngol 62(6):579–582

    Article  CAS  PubMed  Google Scholar 

  15. Rynnel-Dagoo B, Freijd A (1988) Nasopharyngeal lymphoid tissue—a threat to the middle ear? Acta Otolaryngol Suppl 454:208–209

    Article  CAS  PubMed  Google Scholar 

  16. Shin KS, Cho SH, Kim KR, Tae K, Lee SH, Park CW, Jeong JH (2008) The role of adenoids in pediatric rhinosinusitis. Int J Pediatr Otorhinolaryngol 72(11):1643–1650. doi:10.1016/j.ijporl.2008.07.016

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, No. 600, Yi Shan Road, Shanghai, 200233, China

    Ming-Liang Wang, Xiao-Er Wei, Meng-Meng Yu & Wen-Bin Li

  2. Imaging Center, Kashgar Prefecture Second People’s Hospital, Kashgar, 844000, China

    Wen-Bin Li

Authors
  1. Ming-Liang Wang
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  2. Xiao-Er Wei
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  3. Meng-Meng Yu
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Correspondence to Wen-Bin Li.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The institutional ethics review board approved this retrospective study and waived the need for informed consent.

Funding

This study was supported by the National Natural Science Foundation of China (NSFC; Nos. 81271540, 81301213).

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Wang, ML., Wei, XE., Yu, MM. et al. Value of contrast-enhanced MRI in the differentiation between nasopharyngeal lymphoid hyperplasia and T1 stage nasopharyngeal carcinoma. Radiol med 122, 743–751 (2017). https://doi.org/10.1007/s11547-017-0785-z

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  • DOI: https://doi.org/10.1007/s11547-017-0785-z

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