Rouviere's lymph nodes: clinical insights and therapeutic frontiers

Abstract

This study aims to comprehensively examine Rouviere's lymph nodes and their clinical implications. It investigates the frequency, characteristics, and diagnostic significance of Rouviere's lymph nodes in various pathological conditions, emphasizing their relevance in pharyngeal malignancies and potential management strategies. A thorough analysis of the literature, along with subsequent advancements, has been conducted to evaluate Rouviere's lymph nodes' locations, differential diagnosis, associated pathological conditions, diagnostic techniques, and management strategies. Rouviere's lymph nodes, situated in the retropharyngeal region, exhibit specific characteristics and frequencies, particularly in different age groups. They aid in differential diagnoses and identifying metastatic involvement in the posterior pharyngeal wall. Medial lymph nodes are more common in children and tend to be unilateral at the C2-C3 level. Lateral lymph nodes are frequently seen bilaterally in adults, typically positioned at the skull base or the C1-C2 junction. Malignant lymph nodes range from 7 to 30 mm in size and can be easily detected in MRI, especially T2-weighted imaging. Various treatment modalities are employed for managing Rouviere's lymph nodes, including external radiation therapy, transoral sonography coupled with fine-needle aspiration for precise identification, chemoradiotherapy with selective intra-arterial infusion, and cetuximab therapy. These findings highlight the necessity of individualized therapeutic approaches tailored to specific patient attributes and underlying pathological factors.