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Flashcards in Suprahyoid neck Deck (16)
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What is within the parotid space?

1. Parotid gland
2. Lymph nodes (within gland)
3. Facial nerve
4. Retromandibular vein (medial to CN VII)


What are the important features of a pleomorphic adenoma?

1. Most common major and minor salivary gland tumour
2. Most common in the parotid but can occur in others
3. 90% occur in the superficial lobe
4. T2 bright with a rim of low signal
5. Small malignant potential and so treated surgically


What are the important features of a Warthin's tumour?

1. Only occurs in the parotid gland
2. Is bilateral in 15%
3. Usually cystic
4. Takes up pertechnetate
5. Usually seen in male smokers


What are the important features of mucoepidermoid carcinoma?

1. Most common malignant tumour of minor salivary glands
2. Variable appearance
3. Associated with radiation


What are the important features of adenoid cystic carcinoma?

1. Malignant salivary gland tumour which favours minor glands but can be seen in the parotid
2. Can result in perineural spread


What are the important features of lymphoepithelial disease of the parotid gland?

1. Bilateral mixed solid and cystic lesions with diffusely enlarged parotid glands
2. Seen in HIV
3. Is painless (unlike parotitis)


What are the features of Sjogren's to the salivary glands?

1. Honeycomb appearance of the gland
2. Increased risk of non-Hodgkins MALT type lymphoma


What is in the carotid space?

1. Carotid artery
2. Jugular vein
3. Portions of CN IX, X and XI
4. Internal jugular chain lymph nodes


What are paragangliomas?

Vascular tumours arising from neural crest cell derivatives.
"Salt and pepper" appearance from the flow voids and can be multiple/bilateral.
111-In-Octreotide accumulates in these tumours.
4 types:
1. Carotid body tumour at carotid bifurcation
2. Glomus jugulare at skull base with destruction of jugular foramen
3. Glomus vagale above carotid bifurcation and below jugular foramen
4. Glomus tympanicum in the middle ear ("overlying the cochlear promontory") around Arnoldson and Jacobson nerves.


Carotid space mass differential.

1. Squamous cell cancer nodal metastasis
2. Paraganglioma
3. Neurofibroma
4. Schwannoma


What is Lemierre's syndrome?

Lemierre's syndrome refers to the purulent or septic thrombophlebitis of the internal jugular vein as a complication of pharyngitis.
Usually caused by Fusobacterium necrophorum.
Lemierre's disease could be even further complicated by distant metastatic abscesses in the lungs with septic pulmonary emboli, brain abscesses or elsewhere (septic arthritis can lead to acute osteomyelitis).


What is in the masticator space?

1. Muscles of mastication
2. Angle and ramus of the mandible
3. Inferior alveolar nerve (branch of CN V3)
4. Internal maxillary artery


Masticator space pathology differential.

1. Infection - usually odontogenic
2. Sarcomas - rhadomyosarcoma, chondrosarcoma favours the TMJ
3. Cavernous haemangioma
4. Schwannoma
5. Perineural spread from primary melanoma or adenoid cystic tumour


What is in the parapharyngeal space?

1. Predominantly fat
2. Trigeminal nerve (V3)
3. Internal maxillary artery
4. Ascending pharyngeal artery


Parapharyngeal mass differential.

1. Minor salivary gland tumour
2. Lipoma
3. Cellulitis/abscess
4. Schwannoma


How is the parapharyngeal space affected by other neck space lesions?

1. Parotid mass displaces it medially
2. Carotid space causes anterior displacement
3. Masticator space mass causes postero-medial displacement
4. Superficial mucosal space mass causes lateral displacement