Das A, Bhalla AS, Sharma R, Kumar A, Sharma M, Gamanagatti S, Thakar A, Sharma S. Benign neck masses showing restricted diffusion: Is there a histological basis for discordant behavior? World J Radiol 2016; 8(2): 174-182 [PMID: 26981226 DOI: 10.4329/wjr.v8.i2.174]
Corresponding Author of This Article
Ashu Seith Bhalla, Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. ashubhalla1@yahoo.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Abanti Das, Ashu S Bhalla, Raju Sharma, Atin Kumar, Shivanand Gamanagatti, Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi 110029, India
Meher Sharma, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India
Alok Thakar, Suresh Sharma, Department of Otolaryngorhinology, All India Institute of Medical Sciences, New Delhi 110029, India
Author contributions: Das A, Bhalla AS, Sharma R and Kumar A contributed to study design and conception and writing the article; critically analyzing the scientific content and image preparation; Sharma M contributed to image preparation and reviewing the article; Gamanagatti S, Thakar A and Sharma S contributed to article preparation and approving the final version.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ashu Seith Bhalla, Professor, Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. ashubhalla1@yahoo.com
Telephone: +91-011-26594925
Received: June 16, 2015 Peer-review started: June 17, 2015 First decision: August 22 2015 Revised: September 29, 2015 Accepted: December 18, 2015 Article in press: December 21, 2015 Published online: February 28, 2016
Abstract
Diffusion weighted imaging (DWI) evolved as a complementary tool to morphologic imaging by offering additional functional information about lesions. Although the technique utilizes movement of water molecules to characterize biological tissues in terms of their cellularity, there are other factors related to the histological constitution of lesions which can have a significant bearing on DWI. Benign lesions with atypical histology including presence of lymphoid stroma, inherently increased cellularity or abundant extracellular collagen can impede movement of water molecules similar to malignant tissues and thereby, show restricted diffusion. Knowledge of these atypical entities while interpreting DWI in clinical practice can avoid potential misdiagnosis. This review aims to present an imaging spectrum of such benign neck masses which, owing to their distinct histology, can show discordant behavior on DWI.
Core tip: Diffusion weighted imaging improves lesion characterization by providing functional information. However, apart from tissue cellularity, histological background of the lesion can significantly influence the diffusion characteristics of the lesion. Consequently, even benign lesions with atypical histology can show restricted diffusion leading to potential errors in diagnosis.
