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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:1330-1333, August 2003
© 2003 American Society of Neuroradiology

Case Report
HEAD AND NECK

Non-Contrast-Enhanced CT Findings of High Attenuation within Metastatic Cervical Lymph Nodes in Patients with Stage I or II Tongue Carcinoma during a Follow-up Period

Takafumi Hayashi^a, Ray Tanaka^a, Shuhzou Taira^a, Jun-ichi Koyama^a, Kouji Katsura^a and Fukiko Kobayashi^a

^a From the Division of Oral and Maxillofacial Radiology, Course for Oral Life Science, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan

Address correspondence to Takafumi Hayashi, D.D.S., Division of Oral and Maxillofacial Radiology, Course for Oral Life Science, Niigata University Graduate School of Medical and Dental Sciences, 2–5274 Gakkocho-dori, Niigata 951-8514 Japan

Summary: We present the non-contrast-enhanced CT finding of high attenuation within metastatic regional lymph nodes in two patients with stage I or II tongue carcinoma during a follow-up period. The attenuation values of these lesions were approximately 70 HU or more. One patient had a level I node, and the other had a level II node. Contrast-enhanced CT failed to reveal these hyperattenuated areas within the nodes. Histopathologic examination revealed that these hyperattenuated areas were strongly correlated with the area of marked keratinization of metastatic foci. If contrast-enhanced CT had been the only imaging technique used, these lesions might have been overlooked. The clinician should be aware of the characteristic findings of non-contrast-enhanced, as well as contrast-enhanced, CT when investigating lymph node metastases at an early stage in patients with stage I or II tongue carcinoma during the follow-up period.