Lymph Nodes of the Neck

Patterns of Regional Spread for Esthesioneuroblastoma

“…The involvement of level II nodes is not surprising given their known drainage of the nasal cavity and nasopharynx and frequent involvement in other carcinomas from this region. [12][13][14]23 Levels I and III nodes were involved at least 50% of the time.…”

“…Lymph nodes were classified according to surgical levels, with the following additional categories: RPNs and parotid/facial nodes. 12 We evaluated 3 characteristics of the imaging appearance of metastatic lymph nodes: 1) the proportion of the node that enhanced with contrast, as a means of characterizing nodes as cystic or solid in appearance, 2) the degree of contrast enhancement, and 3) the degree of FDG avidity. Because standardized uptake values are not considered a reliable measure of malignancy, FDG avidity was subjectively categorized as absent, low, moderate, or high.…”

“…4,7,[9][10][11] The route of lymphatic spread in other head and neck cancers has been more thoroughly studied and often demonstrates specific patterns. 12,13 Notably, nasopharyngeal carcinoma has been shown to spread primarily to the RPNs.…”

Magnetic resonance imaging staging of nasopharyngeal carcinoma in the head and neck

“…However, it should be noted that normal nodes become progressively smaller moving caudally in the neck and therefore a size of 5-7 mm is sometimes used as a cutoff in the lower neck. NPC nodes are often necrotic and show extracapsular spread and these signs are used by MRI to identify metastatic nodes irrespective of size [33,34] . Extracapsular spread has also been shown to be an independent prognostic factor for overall survival and distant metastases failure-free survival [35] .…”

Imaging of Nasopharyngeal Carcinoma

“…In both N1 and N2, disease is restricted to above the supraclavicular fossa, which is defined by three points: (1) prognosis with a 50% decreased 5-year survival rate [43].…”