{"title":"继发于转移性鳞状细胞癌的淋巴腺病被误认为是恶性淋巴瘤。","authors":"Hye-Bin Jang, Dong Hoon Lee, Joon Kyoo Lee, Sang Chul Lim","doi":"10.1097/SCS.0000000000010801","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>It is difficult to identify disease entities underlying lymphadenopathy in the head and neck region based solely on imaging. This often results in metastatic squamous cell carcinoma (Sqcc)-induced lymphadenopathy being mistaken for lymphoma. This study aimed to analyze clinical characteristics and computed tomographic features that aid in distinguishing between metastatic Sqcc and lymphoma when lymphadenopathy resembles a large solitary lymphoma.</p><p><strong>Methods: </strong>The authors retrospectively enrolled 5 patients, managed between 2010 and 2024, with metastatic Sqcc mistaken for lymphoma and 9 patients with lymphadenopathy of 2 cm or larger due to lymphoma.</p><p><strong>Results: </strong>Among the 5 patients, 3 exhibited a homogeneous lymphadenopathy phenotype, whereas the remaining 2 displayed heterogeneous enhancement with multiple small necrotic areas within the affected masses. Measurement of the Hounsfield units (HU) for lymphadenopathy, the sternocleidomastoid muscle, and the submandibular gland (SMG) was conducted for each patient. The ratio of lymphadenopathy HU to the average HU of the sternocleidomastoid muscle and the SMG was significantly higher in patients diagnosed with metastatic Sqcc compared with those with lymphoma (P = 0.01).</p><p><strong>Conclusion: </strong>In computed tomography scans, heterogeneous lymphadenopathy or enhancement levels that approach or exceed those of the SMG may indicate the likelihood of Sqcc rather than lymphoma.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.0000,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lymphadenopathy Secondary to Metastatic Squamous Cell Carcinoma Mistaken for Malignant Lymphoma.\",\"authors\":\"Hye-Bin Jang, Dong Hoon Lee, Joon Kyoo Lee, Sang Chul Lim\",\"doi\":\"10.1097/SCS.0000000000010801\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>It is difficult to identify disease entities underlying lymphadenopathy in the head and neck region based solely on imaging. This often results in metastatic squamous cell carcinoma (Sqcc)-induced lymphadenopathy being mistaken for lymphoma. This study aimed to analyze clinical characteristics and computed tomographic features that aid in distinguishing between metastatic Sqcc and lymphoma when lymphadenopathy resembles a large solitary lymphoma.</p><p><strong>Methods: </strong>The authors retrospectively enrolled 5 patients, managed between 2010 and 2024, with metastatic Sqcc mistaken for lymphoma and 9 patients with lymphadenopathy of 2 cm or larger due to lymphoma.</p><p><strong>Results: </strong>Among the 5 patients, 3 exhibited a homogeneous lymphadenopathy phenotype, whereas the remaining 2 displayed heterogeneous enhancement with multiple small necrotic areas within the affected masses. Measurement of the Hounsfield units (HU) for lymphadenopathy, the sternocleidomastoid muscle, and the submandibular gland (SMG) was conducted for each patient. The ratio of lymphadenopathy HU to the average HU of the sternocleidomastoid muscle and the SMG was significantly higher in patients diagnosed with metastatic Sqcc compared with those with lymphoma (P = 0.01).</p><p><strong>Conclusion: </strong>In computed tomography scans, heterogeneous lymphadenopathy or enhancement levels that approach or exceed those of the SMG may indicate the likelihood of Sqcc rather than lymphoma.</p>\",\"PeriodicalId\":15462,\"journal\":{\"name\":\"Journal of Craniofacial Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2024-10-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Craniofacial Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/SCS.0000000000010801\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Craniofacial Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SCS.0000000000010801","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
目的：仅凭影像学检查很难确定头颈部淋巴结病的潜在疾病实体。这往往导致转移性鳞状细胞癌（Sqcc）引起的淋巴结病被误认为淋巴瘤。本研究旨在分析当淋巴结病类似大单发淋巴瘤时，有助于区分转移性鳞状细胞癌和淋巴瘤的临床特征和计算机断层扫描特征：作者回顾性研究了2010年至2024年间收治的5例被误诊为淋巴瘤的转移性Sqcc患者和9例因淋巴瘤导致淋巴结肿大2厘米或更大的患者：结果：在这5名患者中，有3名患者的淋巴结病呈同型，其余2名患者的淋巴结病呈异型强化，受累肿块内有多个小坏死区。对每位患者的淋巴腺病、胸锁乳突肌和颌下腺（SMG）进行了霍斯菲尔德单位（HU）测量。与淋巴瘤患者相比，确诊为转移性 Sqcc 患者的淋巴结病 HU 与胸锁乳突肌和 SMG 平均 HU 之比明显更高（P = 0.01）：结论：在计算机断层扫描中，异质性淋巴结病变或增强水平接近或超过胸锁乳突肌的增强水平可能预示着Sqcc而非淋巴瘤的可能性。
Lymphadenopathy Secondary to Metastatic Squamous Cell Carcinoma Mistaken for Malignant Lymphoma.
Objective: It is difficult to identify disease entities underlying lymphadenopathy in the head and neck region based solely on imaging. This often results in metastatic squamous cell carcinoma (Sqcc)-induced lymphadenopathy being mistaken for lymphoma. This study aimed to analyze clinical characteristics and computed tomographic features that aid in distinguishing between metastatic Sqcc and lymphoma when lymphadenopathy resembles a large solitary lymphoma.
Methods: The authors retrospectively enrolled 5 patients, managed between 2010 and 2024, with metastatic Sqcc mistaken for lymphoma and 9 patients with lymphadenopathy of 2 cm or larger due to lymphoma.
Results: Among the 5 patients, 3 exhibited a homogeneous lymphadenopathy phenotype, whereas the remaining 2 displayed heterogeneous enhancement with multiple small necrotic areas within the affected masses. Measurement of the Hounsfield units (HU) for lymphadenopathy, the sternocleidomastoid muscle, and the submandibular gland (SMG) was conducted for each patient. The ratio of lymphadenopathy HU to the average HU of the sternocleidomastoid muscle and the SMG was significantly higher in patients diagnosed with metastatic Sqcc compared with those with lymphoma (P = 0.01).
Conclusion: In computed tomography scans, heterogeneous lymphadenopathy or enhancement levels that approach or exceed those of the SMG may indicate the likelihood of Sqcc rather than lymphoma.
期刊介绍：
The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial surgery, maxillofacial surgery and pediatric plastic surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. The journal publishes original articles, scientific reviews, editorials and invited commentary, abstracts and selected articles from international journals, and occasional international bibliographies in craniofacial surgery.
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