Cervicofacial Actinomycosis: CT and MR Imaging Findings in Seven Patients
Ji Kang Parka,
Ho Kyu Leea,
Hyun Kwon Haa,
Hae Young Choib and
Choong Gon Choia
a Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
b Department of Radiology, Ewha Woman’s University, Seoul, Korea
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FIG 1. Case 1. A 6-year-old girl with an ill-defined lesion of the left pyriform sinus.
A, Contrast-enhanced axial CT scan shows a moderately enhancing mass (black arrows) in the left pyriform sinus. It extends to the submandibular gland (arrowhead) and platysma muscle (white arrow). The left submandibular gland is enlarged and has multiple small nonenhancing portions. Multiple, small, homogeneous, well-defined oval lymph nodes are found in both internal jugular chains (open arrows).
B, Photomicrograph of a specimen shows actinomycotic granules (thin arrows) and adjacent necrosis (arrowheads). These are surrounded by granulation tissue and fibrosis (thick arrows) (hematoxylin-eosin stain, original magnification x200).
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FIG 2. Case 2. A 77-year-old woman with a well-defined buccal-space lesion.
A, Contrast-enhanced axial CT scan shows an elliptical mass (arrows), which extends from the gingiva to the right buccal space. This mass shows moderate contrast enhancement without fat infiltration.
B, Same CT scan obtained with a bone setting shows the mass (arrows).
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FIG 3. Case 3. A 24-year-old woman with an oro- and hypopharyngeal lesion.
A, Contrast-enhanced axial CT scan shows a soft-tissue mass in the right hypopharynx (black arrows). The mass extends to the submandibular gland and to the retropharyngeal, prevertebral, and carotid spaces. This lesion shows moderate contrast enhancement. Several lymph nodes are found in the both internal jugular chains (white arrows).
B, Contrast-enhanced axial CT scan shows a bulky mass with moderate contrast enhancement in the right visceral space. The mass extends to the retropharyngeal space, carotid space, and sternocleidomastoid muscle. A small nonenhancing portion, suggestive of necrotic foci, is found in the mass (arrow).
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FIG 4. Case 4. A 61-year-old man with a lesion of the aryepiglottic fold. Contrast-enhanced axial CT scan shows a moderately enhancing soft-tissue lesion in the right aryepiglottic fold (arrow). This lesion has a relatively well-defined margin and no notable extension into the adjacent soft tissue.
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FIG 5. Case 5. A 80-year-old woman with a tongue lesion. Coronal contrast-enhanced fat-saturated T1-weighted MR image (TR/TE, 533/16) shows a mass with moderate contrast enhancement (arrow).
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FIG 6. Case 6. A 41-year-old man with a nasal-cavity lesion.
A, Axial T1-weighted MR image (480/20) shows an elongated lesion with intermediate signal intensity in the left cavernous sinus and orbital apex (arrow).
B, Axial T2-weighted MR image (2630/80) shows a mass of intermediate signal intensity (arrow).
C, Contrast-enhanced T1-weighted MR image (480/20) shows diffuse contrast enhancement and narrowing of the internal carotid artery (arrow).
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AJNR - American Journal of Neuroradiology