CT and MR imaging findings of chronic, non-infectious inflammatory conditions of the oral cavity mas

초록

Purpose: To investigate the radiologic and pathologic findings of chronic, noninfectious and nontumorous inflammatory conditions which clinically and radiologically simulate mucosal malignancy in the oral cavity. Methods and Materials: CT (n=4) and MR (n=2) images obtained from five patients (three men and two women; mean age, 69 years; age range, 34-98 years) with histologically proved chronic inflammatory mass of the oral cavity were retrospectively reviewed. In all patients, the initial clinical and radiological diagnosis was mucosal carcinoma. Three lesions were located in the oral tongue, one in the hard palate, and the remaining one in both the palate and gingiva. CT and MR images were carefully analyzed to find whether they could afford some useful informations about differentiating these benign inflammatory conditions from more common malignant lesions of the oral cavity. Results: On CT and MR images, all three lesions in the oral tongue were seen as a superficially located, ill-marginated, ellipsoid or ovoid soft tissue mass, one lesion in the hard palate as a relatively well-marginated, elongated mass with peripheral enhancement, and the remaining one lesion in both the palate and gingiva as a diffuse soft tissue mass. Neither clinical manifestations nor radiologic findings of these inflammatory lesions could afford a clue to the correct diagnosis, which therefore should be relied on histologic examinations from surgical specimens. Histopathology revealed variable degrees of acute and chronic inflammation, granulation tissue formation, and fibrosis, accompanied by pseudoepitheliomatous hyperplasia and/or irritation fibroma with a varying thickness. Conclusion: Some forms of chronic, noninfectious inflammatory conditions of the oral cavity are nearly impossible to distinguish from the malignant tumors both clinically and radiologically, and should be included in the list of differential diagnosis of mass and mass-like conditions in this area.