Head and Neck ImagingRetropharyngeal space, pathology
-
InflammationThis is most commonly seen in children. The infection begins in the lymphatic tissue of
Waldeyer's ring
and spreads to the retropharyngeal
lymph nodes, causing adenitis. These nodes may become suppurative and eventually cause
retropharyngeal cellulitis
or a
retropharyngeal abscess
. Also, see
abscess, retropharyngeal
.
-
Congenital lesions
A
vascular malformation, head and neck
or
haemangioma, head and neck
may involve the
retropharyngeal space
.
-
Benign tumours
Very rarely seen; lipoma may be encountered.
-
Malignant tumours
The most common cause of retropharyngeal malignancy is nodal spread of
squamous cell carcinoma, head and neck
(
Fig. 1). This is most commonly seen in cancer of the posterior pharyngeal wall, but also in recurrent cancer at other neck sites. Rarely other malignancies spread to the retropharyngeal nodes; retropharyngeal adenopathy is sometimes seen in
non-Hodgkin lymphoma, head and neck manifestation
. Also, see
level system of lymph node classification
.
Posterior pharyngeal wall cancer may invade the retropharyngeal space directly. Other non-nodal malignancy is very rare.
- Pseudomass
Retropharyngeal space oedema may be seen when there is a venous or lymphatic outflow
obstruction of the neck (e.g. superior vena cava syndrome or after radiation therapy) (
radiation therapy, tissue changes
). The carotid
artery may show pronounced tortuosity and extend into the retropharyngeal space; clinically, this may appear as a submucosal mass
lesion.
RH
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Already registered? Enter your e-mail in the window below.Re-registerFig. 01a
Axial contrast enhanced CT image (level of nasopharynx). Centrally necrotic adenopathy, lymphatic metastasis of recurrent laryngeal squamous cell carcinoma. A retropharyngeal adenopathy is typically situated between the prevertebral muscles (arrowhead) and the internal carotid artery (arrow).
 | |
Retropharyngeal space, pathology, Fig. 01a | |