The role of CT scan in imaging neck structures and lesions: a radiological - histopathological correlation retrospective study at Kenyatta National Hospital

Abstract

Between January and July 2004, histological and radiological records of 42 patients with varied pathologies of the neck were reviewed in a prospective/retrospective study carried out at Kenyatta National Hospital. There were 32 retrospective cases dating back to 2001 and 10 prospective cases collected during the duration of the study. All the patients included in the study had correlating histopathologic data acquired following surgery or biopsy of the lesion. The CT images and histological data formed the basis of my study.

The aim of this study was to show the pattern of disease of the neck as assessed by computed tomography scanning at Kenyatta National Hospital, the age and sex distribution and correlate this to histopathologic fmdings.

This prospective and retrospective study was done at KNH X-Ray Department. Consecutive patients who presented for CT scan examination of the neck during the study period were included. The patient's clinical summary (age, sex, ? radiological diagnosis) was obtained from the request/report form. Histopathology reports for all patients who subsequently underwent biopsy or surgery of the neck pathology were requisitioned from the Pathology department, KNH. Data for the retrospective cases (sequential patients with both sets of data in the period between 2001 and 2003 inclusive) was acquired from the respective KNH departments).

The commonest pathologies encountered were malignancies, with carcinoma of the larynx/hypopharynx and nasopharyngeal tumors constituting 57% of the cases seen. Both showed a male predilection. Mean ages were 55 and 41 years respectively. Other cases of malignancies seen included lymphomas, thyroid tumors, carcinoma of the tongue, Kaposi's sarcoma and hemangioendothelioma. Congenital lesions seen during this study included cystic hygroma and branchial cleft cyst, both of which showed typical imaging findings at CT. Inflammatory lesions demonstrated included submandibular abscess, inflammatory pharyngeal polyps and pharyngeal mucosal adenoids. Cervical lymphadenopathy, either as a primary process or as part of metastatic disease was also seen at CT. All the above cases were subsequently confirmed by histopathology.

Assessment by CT provided a correct diagnosis in 83.3% (sensitivity of 83.3%) of the cases reviewed, with diagnostic difficulties being encountered in only 7 cases (16.7%). This proved CT to be a useful modality in assessment of neck pathology.