[Tuberculoid caseating necrosis of cervical lymph nodes. Ultrasound after radiochemotherapy of undifferentiated nasopharyngeal carcinoma].
Sonography following Radiochemotherapy for Undifferentiated Nasopharyngeal Carcinoma:


OBJECTIVE
An undifferentiated nasopharyngeal carcinoma (UCNT) recurred 5 1/2 months after radiochemotherapy in a 14-year-old Caucasian boy. By ultrasound, multiple lymph nodes, predominantly left sided, were identified both in groups and singly located adjacent to large cervical vessels.


RESULTS
After lymphadenectomy, pathological examination revealed caseation necrosis with epitheloid cells and Langhans [corrected] cells in 2 of 6 enlarged lymph nodes (> 10 mm). The tentative diagnosis of tuberculosis was excluded during (3 years) follow-up.


CONCLUSIONS
Caseation necrosis in lymph node metastases is highly characteristic of UCNT. Sonography failed in the case described to demonstrate differences in lymph nodes with and without caseation necrosis. Differential diagnosis between tuberculous and metastatic cervical lymph nodes must therefore be made by other means (serology, microbiology).
Friedrich
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RE
Klinik für Mund-, Kiefer- und Gesichtschirurgie, (Nordwestdeutsche Kieferklinik, Universitäts-Krankenhaus Eppendorf.
Schmelzle
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R
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D003937:Diagnosis, Differential; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000532:radiotherapy*; D009333:Neck; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000473:pathology; D018714:Radiotherapy, Adjuvant; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging* / Q000473:pathology; D014463:Ultrasonography
Verkäsend-tuberkuloide Nekrosen in Halslymphknoten. Sonographie nach Radiochemotherapie eines undifferenzierten Nasopharynxkarzinoms.