Thoracic metastases from carcinoma of the nasopharynx: high frequency of hilar and mediastinal lymphadenopathy.
OBJECTIVE
Nasopharyngeal carcinoma is a malignant tumor commonly encountered in Chinese patients living in or originating from Hong Kong or southern China. This article describes the previously unreported radiologic appearances of thoracic metastases from nasopharyngeal carcinoma.


METHODS
The radiographic (33 patients) and CT (eight patients) appearances of thoracic metastases from nasopharyngeal carcinoma were studied retrospectively. All 33 patients had biopsy-proved primary nasopharyngeal carcinoma, and seven patients had biopsy-proved thoracic metastases. Radiologic and clinical evidence of metastases was unequivocal in 26 others, 16 of whom had synchronous spread to cervical lymph nodes, bone, or liver.


RESULTS
Twenty-one patients (64%) had evidence of thoracic lymphadenopathy, most frequently hilar (n = 18, 55%), on chest radiographs or CT scans. Seventeen patients (52%) had evidence of multiple parenchymal pulmonary metastases. Enlargement of lymph nodes without multiple pulmonary deposits was seen in 12 patients (36%), seven of whom had radiologic signs of bronchial obstruction, hemoptysis, or a single pulmonary lesion simulating a synchronous bronchial neoplasm. Pleural effusions or deposits (n = 6), lymphangitis carcinomatosa (n = 5), and rib metastases (n = 4) also were seen.


CONCLUSIONS
Metastases from nasopharyngeal carcinoma may be detected in a wide range of thoracic sites. This disease appears to be as likely to disseminate to the mediastinal or hilar lymph nodes as to the pulmonary parenchyma, and it can simulate a primary bronchial tumor or lymphoma.
Daly
B D
BD
Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin.
Leung
S F
SF
Cheung
H
H
Metreweli
C
C
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D014057:Tomography, X-Ray Computed