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head and neck cancers, no lymphatics, RETROPHARYNGEAL NODES - Coggle…
head and neck cancers
WORST PATTERN OF INVASION
GRADE3
invasive islands >15 cells per island
GRADE4
invasive islands < 15 cells per island , including single cell invasion
GRADE2
broad invasive fingers with multiple tumor islands
GRADE5
tumor satellites +/- 1 mm distance from the tumor
GRADE1
Broad invasive front
based on WPOI , change adjuvant treatment
different paths of spread
PNI
Salivary duct
facial plane
direct infiltration
lymphatic
risk of nodal invasion
differentiation
PNI/LVI
depth of invasion
recurrent lesion
subsite
sites rich in lymphatics
base of tongue
pyriform fossa
nasopharynx
size of lesion
usually predictable nodal spread
unpredictable nodal spread in case of
previous surgery
previous RT
high dz burden on side of lesion
UNUSUAL SITE OF NOAL METS , THINK OF SECOND PRIMARY
if clinically NOT PALPABLE DO USG NECK
MANDIBLE INVOLVED
DENTULOUS
occlusal surface
EDENTULOUS
nerve canal
cortical breach
tooth socket
distant metastasis
most common site , lung
no lymphatics
para nasal sinus
middle ear
vocal cord
RETROPHARYNGEAL NODES
OROPHARYNX