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Cervicothoracic Lesions in Infants and Children¹

¹ From the Department of Radiology, Institut de Diagnostic per la Imatge, Hospital Materno-Infantil Vall d'Hebron, Paseo Vall d'Hebron 119–129, E-08035 Barcelona, Spain (A.C., E.V., J.V., J.P., J.L., P.G.P.); and the Department of Radiology, Hospital Germans Trias i Pujol, Badalona, Spain (J.A.J.). Recipient of a Certificate of Merit award for a scientific exhibit at the 1997 RSNA scientific assembly. Received April 17, 1998; revision requested May 14 and received July 8; accepted July 9. Address reprint requests to A.C.

Cervicothoracic lesions are not uncommon in children. All cervicothoracic lesions except superficial lesions extend from the neck to the thorax through the thoracic inlet. Evaluation of this area involves multiple imaging modalities: plain radiography, ultrasonography, nuclear medicine, computed tomography, and magnetic resonance (MR) imaging. However, MR imaging is the method of choice for assessing the full extents of cervicothoracic lesions and their relationships to neurovascular structures. Cervicothoracic lesions can be classified as congenital lesions, inflammatory lesions, benign tumors, malignant tumors, and traumatic lesions. Lymphangioma is the most common cervicothoracic mass in children; other congenital lesions include hemangioma, thymic cyst, and vascular anomalies. Inflammatory adenopathy reactive to tuberculosis, mononucleosis, tularemia, cat-scratch fever, infection with human immunodeficiency virus, or other upper respiratory tract infections can manifest as cervicothoracic lesions; tuberculous abscesses and abscesses of other origins can also be seen. Lipoma, lipoblastoma, aggressive fibromatosis, and nerve sheath tumors (either isolated lesions or those associated with neurofibromatosis) can also occur as cervicothoracic masses. Malignant cervicothoracic tumors include lymphoma, thyroid carcinoma, neuroblastoma, and chest wall tumors (rhabdomyosarcoma, Ewing sarcoma, and neuroectodermal tumor). Traumatic cervicothoracic lesions include pneumomediastinum of traumatic origin, traumatic pharyngeal pseudodiverticulum, esophageal foreign-body granuloma, and cervicothoracic hematoma.

Index Terms: Head and neck neoplasms, 27.30 • Mediastinum, abnormalities, 67.20, 67.30, 67.40 • Neck, abnormalities, 27.1499, 27.36 • Neck, infection, 27.20 • Neck, injuries, 27.40 • Thorax, abnormalities • Thorax, MR, 60.1214

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