Clinical radiology · 2025
Imaging features of non-nasopharyngeal lymphoepithelial carcinoma of the head and neck.
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Li K Y, Kwok H M, Leung H S, Ma K F Johnny, Wong K T, King A D
Аннотация
AIM: Lymphoepithelial carcinoma (LEC) of the head and neck is rare outside the nasopharynx. Radiological literature describing its appearances is limited. Our study aims to summarise the imaging features and clinical characteristics.
MATERIALS AND METHODS: This is a retrospective cohort study on pathologically proven cases of LEC from two local major hospital clusters. Multimodality pretreatment imaging features were studied. Demographics and clinical information, including treatment, recurrence-free survival (RFS) and overall survival (OS) were also evaluated.
RESULTS: Thirty LECs were identified in thirty patients, comprising 19 in the major salivary glands and 11 outside the major salivary glands. Tumours showed T2 intermediate signal, restricted diffusion (mean apparent diffusion coefficient [ADC] 0.701x10-3 mm2/s), moderate enhancement, and high 18F-fluorodeoxyglucose (FDG) avidity. Ill-defined margins (90%) and invasion of adjacent structures (43.3%) were common, notably 73.7% of major salivary gland tumours showed extensive glandular invasion. Nodal metastases were common, in 21/30 (70%), and 38.1% showed necrosis. RFS was worse in the presence of nodal metastasis (P = 0.038) but not in OS, with a mean follow-up time of 53.5 months. There were no significant differences in RFS or OS between LEC patients treated with or without surgery, or between major salivary gland and nonmajor salivary gland LECs.
CONCLUSION: Head and neck LEC shows intermediate T2W signal, moderate enhancement, diffusion restriction, high FDG avidity and a propensity for nodal metastasis with necrosis, similar to those described in the literature for NPC. Recurrence-free-survival was worse in the presence of nodal metastases but was similar when treated by surgery or chemo-radiotherapy.
MATERIALS AND METHODS: This is a retrospective cohort study on pathologically proven cases of LEC from two local major hospital clusters. Multimodality pretreatment imaging features were studied. Demographics and clinical information, including treatment, recurrence-free survival (RFS) and overall survival (OS) were also evaluated.
RESULTS: Thirty LECs were identified in thirty patients, comprising 19 in the major salivary glands and 11 outside the major salivary glands. Tumours showed T2 intermediate signal, restricted diffusion (mean apparent diffusion coefficient [ADC] 0.701x10-3 mm2/s), moderate enhancement, and high 18F-fluorodeoxyglucose (FDG) avidity. Ill-defined margins (90%) and invasion of adjacent structures (43.3%) were common, notably 73.7% of major salivary gland tumours showed extensive glandular invasion. Nodal metastases were common, in 21/30 (70%), and 38.1% showed necrosis. RFS was worse in the presence of nodal metastasis (P = 0.038) but not in OS, with a mean follow-up time of 53.5 months. There were no significant differences in RFS or OS between LEC patients treated with or without surgery, or between major salivary gland and nonmajor salivary gland LECs.
CONCLUSION: Head and neck LEC shows intermediate T2W signal, moderate enhancement, diffusion restriction, high FDG avidity and a propensity for nodal metastasis with necrosis, similar to those described in the literature for NPC. Recurrence-free-survival was worse in the presence of nodal metastases but was similar when treated by surgery or chemo-radiotherapy.