FACIAL LYMPH-NODES - NORMAL AND ABNORMAL CT APPEARANCE

Facial lymph node involvement by neoplastic disease is an unusual occu rrence. The purpose of this study was to determine the normal and abno rmal radiologic appearance of the facial nodes. Two hundred enhanced c omputed tomographic (CT) studies of patients not at risk for facial no de metastasis were studied prospectively to establish a normal control group. One hundred consecutive patients with extensive recurrent or p rimary cancer of the epidermal structures of the face, the sinonasal r egion or deep face, or the mucosal surface of the oral cavity were exa mined prospectively to establish a prevalence for metastatic facial ad enopathy. In addition, all cases of facial node metastases seen on ima ging studies over an 11-year period (n = 21) were examined retrospecti vely to establish the spectrum of facial lymphadenopathy. Normal nodes could not be confidently identified on CT studies. When nodal metasta sis occurred, it was often in the setting of recurrent disease. The in fraorbital nodes tended to be the site of origin for lymphomas isolate d to the canine fossa.