Role of Cross-Sectional Imaging in Tongue Lesions

Role of Cross-Sectional Imaging in Tongue Lesions

  • Deepthi BT Junior resident, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Gautham M Professor, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Jefrin Roy Mathew Junior resident, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India https://orcid.org/0000-0003-2904-7446

Abstract

Background: The purpose of this study was to determine the role of CT and MR imaging in demonstrating lesions of the tongue. Imaging    can help to decide the further management of the patient, and when resection is considered, the precise extent of the lesion can be delineated, and also if organ conservation therapy can be suggested. Hence, knowing the differentiating characteristics of these lesions is essential for        a Radiologist to narrow the differential diagnosis. The aim of the study is to describe the imaging findings of various tongue lesions, give radio-pathological correlation, and discuss the role of CT and MRI in planning further appropriate treatment, the extent of involvement of adjacent structures, resectability, postoperative reconstruction & prognosis. Subjects and Methods: Twenty patients with tongue masses were prospectively evaluated with CT & MRI for eighteen months from June 2018 - Nov 2019. Contrast-enhanced CT axial images with reconstruction were acquired. MRI plain & contrast study done. Imaging findings & diagnoses were later correlated with surgical and histopathological results in all possible cases. Results: Among twenty patients, three patients revealed no abnormality; seventeen patients with findings on imaging include twelve squamous cell carcinoma, two venous malformations, two thyroglossal cysts, one hemangioma & one fatty lipoma. Conclusion: Few specific lesion characteristics can aid in narrowing the differential diagnosis. Solid high-density lesions in the midline mostly represent lingual thyroids. Calcifications likely indicate goitrous transformation. Phleboliths are highly suggestive of venous malformations. Multinodular, thin-rim enhancing cystic lesions are indicative of lymphatic malformations, primarily when fluid-fluid levels are found. Fat/calcium content within a complex cystic lesion is specific for a dermoid cyst, whereas diffusion restriction within a pure cystic lesion is suggestive of an epidermoid cyst. Finally, when an injury is Trans spatial, three differentials to be considered are highly aggressive malignancies, congenital masses & aggressive infections.

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References

Badar Z, Farooq Z, Zaccarini D, Ezhapilli SR. Tongue base schwannoma: differential diagnosis and imaging features with a case presentation. Radiol Case Rep. 2016;11(4):336–340. Available from: https://dx.doi.org/10.1016/j.radcr.2016.10.001.

Sankaranarayan R, Masuyer E, Swaminathan R, Ferley J, Whelan S. Head and neck cancer: A global perspective on epidemiology and prognosis. Anticancer Res. 1998;18:4779– 86.

Sigal R, Zagdanski AM, Schwaab G, Bosq J, Auperin A, Laplanche A, et al. CT and MR imaging of squamous cell carcinoma of the tongue and floor of the mouth. RadioGraphics. 1996;16(4):787–810. Available from: https://dx.doi.org/10.1148/radiographics.16.4.8835972.

II RKH, Strain JD. MRI-compatible audio/visual sys- tem: impact on pediatric sedation. Pediatric Radiology. 2001;31(4):247–250. Available from: https://dx.doi.org/10.1007/s002470100426.

Subramanian K, Ramachandran R, Chandrasekharan A, Ran- gasami R, M VSP, Joseph S. Imaging in benign and malignant mass lesions of the tongue. IJAM. 2016;3(1):57–62. Available from: http://dx.doi.org/10.18203/2349-3933.ijam20160189.

Meesa IR, Srinivasan A. Imaging of the Oral Cavity. Radiologic Clin North Am. 2015;53(1):99–114. Available from: https://dx.doi.org/10.1016/j.rcl.2014.09.003.

Ozturk M, Mavili E, Erdogan N, Cagli S, Guney E. Tongue abscesses: MR imaging findings. Am J Neuroradiol.

;27(6):1300–1303.

Patel S, Bhatt AA. Thyroglossal duct pathology and mimics. Insights Imaging. 2019;10:1–12. Available from: https://dx.doi.org/10.1186/s13244-019-0694-x.

Chandra RK, Maddalozzo J, Kovarik P. Histological Characterization of the Thyroglossal Tract: Implications for Surgical Management. Laryngoscope. 2001;111(6):1002– 1005. Available from: https://dx.doi.org/10.1097/00005537-200106000-00014.

Koeller KK, Alamo L, Adair CF, Smirniotopoulos JG. From the Archives of the AFIP. Radio Graphics. 1999;19(1):121–146. Available from: https://dx.doi.org/10.1148/radiographics.19.1.g99ja06121.

Donnelly LF, Jones BV, L J. Imaging of pediatric tongue abnormalities. Am J Roentgenol . 2000;175(2):48993–48995. Available from: https://doi.org/10.2214/ajr.175.2.1750489.

Huang SH, Hwang D, Lockwood G, Goldstein DP, O’Sullivan B. Predictive value of tumor thickness for cervical lymph-node involvement in squamous cell carcinoma of the oral cavity. Cancer. 2009;115(7):1489–1497. Available from: https://dx.doi.org/10.1002/cncr.24161.

Arakawa A, Tsuruta J, Nishimura R, Sakamoto Y, Korogi Y, Baba Y. MR imaging of lingual carcinoma: Comparison with surgical staging. Radiat Med. 1996;14:25–29.

Chung TS, Yousem DM, Seigerman HM, Schalkman BN, Weinstein GS, Hayden RE. MR of mandibular invasion in patients with oral and oropharyngeal malignant neoplasms. Am J Neuroradiol. 1994;15:1949–1955.

Imaizumi A, Yoshino N, Yamada I, Nagumo K, Amagasa T, Omura K. A potential pitfall of MR imaging for assessing mandibular invasion of squamous cell carcinoma in the oral cavity. Am J Neuroradiol. 2006;27:114–122.

Published
2020-06-25
How to Cite
Deepthi BT, Gautham M, & Mathew, J. R. (2020). Role of Cross-Sectional Imaging in Tongue Lesions. Asian Journal of Medical Radiological Research, 8(1), 58-63. https://doi.org/10.47009/ajmrr.2020.8.1.12