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Differential Diagnosis of Sinonasal Extramedullary Plasmacytoma, Non-Hodgkin's Lymphoma, and Squamous Cell Carcinoma Using CT Scan and MRI

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Abstract
Background: The imaging features of sinonasal extramedullary plasmacytoma (EMP) are non-specific and similar to those of other lesions, such as sinonasal non-Hodgkin's lymphoma (NHL) and squamous cell carcinoma (SCC).

Objectives: To analyze the computed tomography (CT) and magnetic resonance (MR) images of patients with EMP, NHL, and SCC to identify the radiological characteristics differentiating sinonasal EMP from NHL and SCC.

Patients and Methods: In this cross-sectional study, the CT and MR imaging features of 37 patients with sinonasal EMP, 46 patients with NHL, and 44 patients with SCC were analyzed. Sinonasal NHL was categorized into two distinct types, namely, natural killer/Tcell lymphoma (n = 32) and diffuse large B-cell lymphoma (n = 14). The tumor volume was determined by measuring the region of interest (ROI) in the PACS program. Besides, homogeneity, apparent diffusion coefficient (ADC) in the ADC maps, degree of enhancement, adjacent bone destruction, and invasion to Waldeyer's ring and cervical or retropharyngeal lymph nodes were evaluated.

Results: Although the tumor volume was larger in the EMP group as compared to the NHL and SCC groups, the difference was not statistically significant. The NHL group showed the highest tumor homogeneity on both CT and MR images. EMP was more heterogenous than NHL, with moderate signal intensity on T1-weighted MR images. On the other hand, EMP and NHL showed significantly lower ADCs as compared to SCC. The majority of patients with sinonasal EMP, NHL, and SCC showed an avid enhancement. Also, destructive tumor growth involving the adjacent bone was more frequent in SCC than in EMP or NHL. However, there were no significant differences among sinonasal EMP, NHL, and SCC in terms of invasion to Waldeyer's ring and cervical or retropharyngeal lymph node metastasis.

Conclusion: Marked heterogeneity on T1-weighted images, low ADCs, and lack of adjacent bone destruction were the CT and MR imaging features that favored the diagnosis of EMP over NHL or
Author(s)
유명상dong-joo leehak-jin kimjoo-yeon kimkyu-sup choSANG DUK HONGsue-jean munsung jae heosung-dong kimtae young jung
Issued Date
2021
Type
Article
Keyword
Keywords: PlasmacytomaNon-Hodgkin’s LymphomaSquamous Cell CarcinomaParanasal Sinus NeoplasmSpiral Computed TomographyMagnetic Resonance Imaging
DOI
10.5812/iranjradiol.111764
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8068
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_crossref_primary_10_5812_iranjradiol_111764&context=PC&vid=ULSAN&lang=ko_KR&search_scope=default_scope&adaptor=primo_central_multiple_fe&tab=default_tab&query=any,contains,Differential%20Diagnosis%20of%20Sinonasal%20Extramedullary%20Plasmacytoma,%20Non-Hodgkin%27s%20Lymphoma,%20and%20Squamous%20Cell%20Carcinoma%20Using%20CT%20Scan%20and%20MRI&offset=0&pcAvailability=true
Publisher
IRANIAN JOURNAL OF RADIOLOGY
Location
네덜란드
Language
영어
ISSN
1735-1065
Citation Volume
18
Citation Number
2
Citation Start Page
0
Citation End Page
0
Appears in Collections:
Medicine > Medicine
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