Patient History
Right neck mass. No mucosal lesion identified on physical examination.
Findings
Contrast-enhanced CT was performed from the skull base through the thoracic inlet. The study demonstrates multiple enlarged lymph nodes involving the right side of the neck. There is a conglomerate group of metastatic lymph nodes involving right level 2. There are multiple metastatic lymph nodes involving right level 3 and a probable small metastatic lymph involving level 4. This lateral lymph node measures approximately 7 mm in largest dimension. However, this is likely metastatic due to the fact that it is associated with multiple ipsilateral metastatic lymph nodes and is also asymmetrically enlarged compared to the left neck.
Imaging of the neck shows no evidence of aggressive lesions involving the nasopharynx, right tongue base, larynx or hypopharynx.
Visualized portion of the brain is grossly within normal limits. However, dedicated brain imaging is necessary for complete diagnostic evaluation.
Visualized portion of the chest demonstrates sternotomy wires and vascular clips. However, dedicated brain imaging is necessary for complete diagnostic evaluation.
Conclusions
Multiple right-sided metastatic lymph nodes with suspicious area involving the right tonsil. However, no lesion was seen at endoscopy.
Sternotomy wires and vascular clips.
