头颈部癌的临床表现多种多样。有一种可先出现颈淋巴结转移或表现其他症状而查不出上呼吸消化道的原发病变,这种情况虽不多见但很重要。过去,对原发于粘膜下的癌肿无简单的检查方法可用以确诊。近5年来,作者们用CT检查对发现上呼吸消化道的粘膜下型癌很有价值。本文报告了19例上呼吸消化道癌,其中9例原发于鼻咽部,2例原发于扁桃体,5例原发于舌根,3例原发于梨状窝或喉部。作者根据其临床表现及物理检查所见将之分成三组:(1)未查见原发肿瘤,物理检查正常或有异常者。本组共9例患者,其上呼吸消化道粘膜无异常亦未见原发肿瘤(3例有粘膜卜肿块)。用CT检查结果:5例为鼻咽癌,5例为口咽和舌根癌(1例并有鼻咽及口咽部癌)。鼻咽部病变有3例作了活检,其中1例是腺癌,另2例及所有口咽舌根部肿 The clinical manifestations of head and neck cancer are diverse. There is a primary lesion that can occur with lymph node metastasis or other symptoms that cannot be found in the upper gastrointestinal tract. This is rare but important. In the past, there was no simple method for the diagnosis of primary cancer that was submucosal. In the past five years, the authors have used CT examinations to be valuable for finding submucosal cancers in the upper respiratory tract. This paper reports 19 cases of upper respiratory tract cancers, of which 9 were primary in the nasopharynx, 2 in the tonsils, 5 in the tongue root, and 3 in the piriform or throat. The authors divided them into three groups according to their clinical manifestations and physical examination findings: (1) Primary tumors were not found, and physical examinations were normal or abnormal. A total of 9 patients in this group had no abnormal epithelial gastrointestinal tract mucosa and no primary tumor (3 cases had mucosal lumps). CT examination results: 5 cases of nasopharyngeal carcinoma, 5 cases of oropharyngeal and tongue base cancer (1 case with nasopharyngeal and oropharyngeal cancer). Biopsy was performed in 3 cases of nasopharyngeal lesions, including 1 case of adenocarcinoma, and 2 cases of all oropharyngeal tongue root swelling