Differential diagnosis of 'carotid body' paraganglioma and lesions mimic 'carotid body' paraganglioma

Head and neck paragangliomas are located in critical anatomic regions where can cause high morbidity and mortality risks, such as carotid bifurcation. In the recent literature, while lots of articles about imaginig characteristics of neck masses and vascular anomalies are present, publications about lesions mimic CBP are mostly contain case reports. We aim to contribute differential diagnosis of CBP and the other lesions originated from this critical anatomic location with objective criterias. 3 vagal paraganglioma, 1 thyroid papiller carcinoma, 1 lympathic metastasis of thyroid carcinoma, 1 ectopic thyroid, 1 venous malformation, 1 ancient schwannoma, 1 composite paraganglioma, 1 thrombosed vessel and foreign body reaction cases were defined in the lesions mimic CBP group. We compared two groups with demographic characteristics, symptoms, signs, USG and MR characteristics, accompanied number of lympadenopathy, intraoperative blood loss, operation time and hospitalisation period. We used the MR classification associated ICA contact degree (Tip I <180°, 180° 270°).While there are statistically significant differences are founded in pain, tinnitus, Fontaine sign and bruit, there is no statistically significant difference in pulsation between two groups. In USG echogenicity and MR intensity characteristics, Lyre sign, salt-pepper apperance, ICA displacement to posterior, ECA displacement to anterior, presence of CCA contact, accompanied number of lympadenopathy, intraoperative blood loss, there are statistically significant differences between two groups are founded. Correlations in 'MR mean volüme- ICA contact degree associated classification', 'MR presence of CCA contact- ICA contact degree associated classification' and 'MR mean volüme- presence of CCA contact' are analysed in both groups. While there is no correlation in lesions mimic CBP group, statistically significant correlation is founded in CBP group. We explained the causes of presence of CCA contact and characteristics of displacements of carotid arteries with natural growth patern hypothesis of CBP and LM-CBP. As a result of these findings, especially radiologic characteristics and datas of from symptoms to hospitalisation period provide us objective criterias for diagnosing CBP. Key Words: 'Carotid Body', Paraganglioma, Imaging, Lateral Neck Masses