Unusual lesions in the retropharyngeal space - a pictorial review

Abstract

The concept of neck spaces has been widely described to assist radiologists in approaching pathology and establishing a differential diagnosis. One of these spaces, the retropharyngeal space (RPS), spans both the suprahyoid and infrahyoid neck, extending from the skull base to the superior mediastinum, and contains only fat and lymph nodes, thus limiting the number of possible differential diagnoses. Despite this, pathologies affecting this space can produce significant morbidity and the RPS is clinically difficult to assess by direct inspection or physical examination. Fortunately, imaging can readily examine the RPS and consequently plays a crucial role in not only determining the extent, but also the character, of any abnormality as well as any associated complications. In this pictorial review, we present a range of unusual conditions that can affect this space and provide some key imaging concepts to aid diagnosis and help guide patient management.