Report:
CT of the neck
Clinical History: pain in angle of mandible/left neck pain prior hx of melanoma
Technique: 2 mm axial CT images of neck were obtained after IV contrast administration. Coronal and sagittal reconstructed images were also obtained.
Findings:
Moderate soft tissue thickening in the posterior nasopharynx. Nodular soft tissue thickening in the left side of the
oropharynx. Mildly prominent soft tissue thickening in the right side of the tongue base. The epiglottis is normal in configuration. The bilateral pyriform sinuses and aryepiglottic folds are grossly symmetric. The vocal cords are grossly symmetric. There is no subglottic mass. The bilateral parotid glands and submandibular glands are grossly symmetric, without evidence of discrete mass. The thyroid gland is unremarkable.
There are multiple lymph nodes in bilateral neck, measuring up to 1.1 x 0.6 cm in the right level 2 area a 1.3 x 0.7 cm in the left
level 2 area.
Mural calcification in bilateral carotid bulbs and proximal ICAs
are present, but no significant stenosis. There are mucosal thickening and retention cysts in bilateral maxillary sinuses.
There are dense bony protuberance arising from the hard palate at the midline, likely representing a torus palatinus.
There are small sclerotic focus in the posterior process of C7 and in the posterior portion of the left first rib. There are mild degenerative changes of the cervical spine. Impression:
1. Soft tissue thickening in the posterior nasopharynx and in the left side of the oropharynx. Mild soft tissue thickening in the right side of the tongue base. Direct inspection is suggested.
2. Multiple lymph nodes in bilateral neck, measuring up to 1.1 x 0.6 cm in the right level 2 area and 1.3 x 0.7 cm in the left
level 2 area.
3. Paranasal sinus disease. 4. Torus palatinus.
5. Sclerotic foci in C7 and left first rib. These could represent small bone islands, although other possibilities cannot be excluded. Nuclear bone scan may be helpful for further evaluation.
Primary Diagnostic Code: ABNORMALITY, ATTN. NEEDED Secondary Diagnostic Codes:
NEEDS FOLLOWUP..... ...I will be going to a new doctor (ENT) on the 16th. and a bone scan on the 24th of April . Thank you for any help.......Nick ( pappy5454)