Demographics:
44 years old, Male
Indication:
Left neck swelling
Findings
- Enlarged, enhancing left level IIa lymph node, measuring approximately 3.5 cm in long axis with areas of internal hypoattenuation and surrounding fat stranding
- Several nearby smaller lymph nodes also show areas of internal hypoattenuation
- Asymmetric enlargement of the left palatine tonsil with soft tissue fullness extending into the left glossotonsillar sulcus
- Mucosal thickening of the paranasal sinuses with fluid levels in the right sphenoid and maxillary sinuses
- Multilevel cervical spondylosis, most advanced at C5-C6 and C6-C7
Diagnosis
Metastatic head and neck cancer
Sample Report
Asymmetric enlargement of the left palatine tonsil with soft tissue fullness extending into the left glossotonsillar sulcus concerning for primary tonsillar neoplasm. Multiple centrally hypoattenuating left level II lymph nodes are concerning for necrotic nodal metastases. Fat stranding around the largest left level IIa lymph node raises concern for extracapsular extension, with suppurative adenitis favored less likely. Recommend ENT referral for further evaluation.
Fluid levels in the right maxillary and sphenoid sinuses are nonspecific but can be seen with acute sinusitis.
Discussion
References