Updated WHO nomenclature of head and neck lesions and associated imaging findings

Abstract

This article reviews the imaging features of head and neck lesions with updated 2017 World Health Organization (WHO) nomenclature. The major WHO changes include refined terminology of existing entities, descriptions of new tumor types, elimination of defunct categories, and updated biological characterization of various tumor types. In particular, the updates pertaining to the following conditions will be reviewed: tumors of the oral cavity and oropharynx, including HPV-positive or HPV-negative squamous cell carcinoma, small cell carcinoma; tumors of the hypopharynx, larynx, trachea, and parapharyngeal space, including nomenclature revisions for laryngeal neuroendocrine tumors; tumors of the nasal cavity and paranasal sinuses including newly added entities such as NUT carcinoma and biphenotypic sinonasal sarcoma; odontogenic and maxillofacial bone tumors, including the reversal of terminology for certain cystic lesions; tumors of the salivary glands, including updated terminology related to high-grade transformation and polymorphous adenocarcinomas tumors; temporal bone lesions including modifications of the nomenclature and classification criteria; tumor-like lesions of the neck and lymph nodes, with a discussion encompassing developmental cysts, metastases of unknown primary, and heterotopia-associated neoplasia; and mucosal melanoma. Familiarity with the proper WHO terminology for conditions that might be mentioned in differential diagnoses and a general understanding of the behavior of head and neck lesions can help optimize imaging assessment and reporting.

Advantages of the open approach in sinonasal tract tumors with midfacial and suprastructure invasion

“…The majority of the patients suffer from chronic crusting rhinitis, epiphora and sensory loss in the ophthalmic or infraorbital territories after rhinotomies. Following the French Society of ENT (Société Française d'Oto-Rhino-Laryngologie -SFORL) 2008 guidelines, the follow-up must consist in clinical examination every two months for the first year, every three months for the second year, then every six months for life; MRI every three months after treatment, then determined by clinical examination, and chest X-ray at 6 months followed by once a year [14][15][16] .…”

Cross-Sectional Imaging of Third Molar–Related Abnormalities

“…Unlike odontogenic keratocysts, ameloblastomas have a propensity for buccolingual expansion in the mandible. 35,38 MR imaging typically reveals high signal intensity on T2-weighted images. Both contrastenhanced CT and MR imaging show enhancing septations, mural nodules, or both in classic cases; these enhancing components are more easily detectable on MR imaging scans, which are also useful for evaluating extraosseous components, including involvement of neurovascular structures (Fig 11 and On-line Fig 3).…”

Tumoren der Mundhöhle

“…Aufgrund zervikaler Lymphknotenmetastasen, wie sie in bis zu 80 % der Fälle auftreten, ist häufig eine radikale oder selektive Lymphadenektomie ("cervical neck dissection") nötig. Trotz der komplexen Therapieansätze liegt das 5-Jahres-Überleben des PECA der Mundhöhle bei nur 40-50 %, in fortgeschrittenen Fällen unter 12 %, wobei HPV-negative prognostisch günstiger als HPV-positiven PECA sind [9,11].…”

“…In der überarbeiteten 4. Version der WHO-Klassifikation der Kopf-Hals-Tumoren von 2017 wird auf dieser Grundlage zwischen HPV-positiven und -negativen PECA unterschieden [ 11 ].…”

“…WHO-Klassifikation der Kopf-Hals-Tumoren von 2017 mit dem kribriformen Adenokarzinom der kleinen Speicheldrüsen (KAC) zusammengefasst unter dem Begriff polymorphes Adenokarzinom (PAC). Das PNGA ist mit 41 % der zweithäufigste maligne Tumor der kleinen Speicheldrüsen; für das KAC wurden hingegen nur wenige Fälle in der Literatur beschrieben [ 11 ]. Die Inzidenz des PNGA wird mit etwa 0,05/100.000 angegeben, wobei Frauen gegenüber Männern in etwa doppelt so häufig betroffen sind, vorrangig ab einem Alter von 40 bis 79 Jahren [ 13 ].…”