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American Journal of Roentgenology, Vol 160, 241-244, Copyright © 1993 by American Roentgen Ray Society

ARTICLES

Thoracic metastases from carcinoma of the nasopharynx: high frequency of hilar and mediastinal lymphadenopathy

BD Daly, SF Leung, H Cheung and C Metreweli
Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin.

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. MATERIALS AND 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. CONCLUSION. 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.
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Copyright © 1993 by the American Roentgen Ray Society.