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Nasopharyngeal Carcinoma Radiology

last modified on: Mon, 03/25/2024 - 09:08

return to: Nasopharyngeal Carcinoma

  • Epithelial carcinoma which arises from the mucosa of the nasopharynx (Chen et al. 2019)
  • Pathological subtypes include keratinizing squamous cell carcinoma, differentiated or undifferentiated non-keratinizing carcinoma, and basaloid squamous cell carcinoma (Chang et al. 2021)
  • Common locations are in the pharyngeal recess and lateral roof (King 2022)
  • Strong association with EBV infection (Chang et al. 2021)
  • More common in southern China, Southeast Asia, North Africa, Greenland, and Alaska (King 2022)
  • Male to female ratio of 2.5:1 (Chen et al. 2019)
  • In the early stages, patients may experience nasal congestion, epistaxis, hearing loss, or no symptoms (King 2022)
  • In the later stages, patients may experience neurologic defects or a neck lump (King 2022)
  • Nodal metastases may occur in 80% of cases (King 2022)
  • Spread patterns
    • Anterior: into nasal cavity and pterygopalatine fossa
    • Anterio-inferior: submucosal spread to palate, levator veli palatini invasion can cause eustachian obstruction and serous otitis media
    • Lateral: parapharyngeal space
    • Posterior: prevertebral musculature
    • Inferior: soft palate and tonsils
    • Superior: anterior clivus, sphenoid sinus, foramen lacerum and internal carotid artery (perivascular), cranial nerve V3 and foramen ovale
  • MR is the imaging of choice for staging (King 2022)
  • Mildly enhances on contrast-enhanced CT, low signal on T1-MR, high signal on T2-MR, mild enhacement on T1 post-contrast MR

References

Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet. 2019 Jul 6;394(10192):64-80. doi: 10.1016/S0140-6736(19)30956-0. Epub 2019 Jun 6. PMID: 31178151.

King AD. MR Imaging of Nasopharyngeal Carcinoma. Magn Reson Imaging Clin N Am. 2022 Feb;30(1):19-33. doi: 10.1016/j.mric.2021.06.015. PMID: 34802578.

Chang ET, Ye W, Zeng YX, Adami HO. The Evolving Epidemiology of Nasopharyngeal Carcinoma. Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1035-1047. doi: 10.1158/1055-9965.EPI-20-1702. Epub 2021 Apr 13. PMID: 33849968.