Lesions involving retropharyngeal space

Introduction:

Lesions involving the retropharyngeal space can be best classified according to the lesions involving its various contents. A good knowledge of the anatomical contents of this space will make the diagnosis of lesions involving this space a bit easier.

Contents of retropharyngeal space:

1. Fat
2. Lymph nodes – Lateral retropharyngeal group (Rouviere) and medial retropharyngeal group.


Pseudomass lesions involving retropharyngeal space include:

1. Tortuous internal carotid artery
2. Mucosal oedema involving the space. This is common in venous obstruction.
3. Lymph spilling into this space due to obstruction to the lymphatic circulation


Congenital mass lesions:

1. Hemangioma
2. Lymphangioma


Inflammatory lesions involving retropharyngeal space:

1. Reactive lymphadenitis
2. Suppurative lymphadenopathy also known as intranodal abscess
3. Cellulitis / abscess

Benign tumor:

Commonest benign tumor involving this space is the lipoma

Malignant tumors involving retropharyngeal space:

1. Nodal metastasis from carcinoma of head and neck
2. Melanoma
3. Lymphomas (Non Hodgekins type is common)
4. Direct invasion of tumors like meningioma and chordoma