“CT Scan Results (Not sure if I should be nervous)”
Impression
Rounded and slightly enlarged left level 1B node with loss of normal fatty hila. While this may be reactive, continued attention on follow-up for consideration to tissue sampling may be warranted.
Electronically Signed By: Kathryn Dean on October 31, 2022 09:01 AM
Narrative
EXAM:
CT NECK SOFT TISSUES WITH IV CONTRAST
CLINICAL HISTORY:
submandibular swelling
TECHNIQUE:
Using a multi-detector CT, a helical acquisition of the neck from the skull base to the thoracic inlet was performed during intravenous contrast infusion. Omnipaque 300 was administered IV for the study with a saline push. The exam was performed at 0.625 mm collimation, and reconstructed at 2.5 mm thickness at 1.25 mm intervals. Coronal and sagittal reconstructions were also performed and reviewed.
COMPARISON:
None available.
FINDINGS:
Nasopharynx/Skull Base: The fat planes at the skull base and the soft tissues of the nasopharynx are unremarkable. There is rightward nasal septal deviation. Scattered polypoid mucosal thickening is noted in the paranasal sinuses. The mastoids and middle ear clefts are unremarkable. The partially visualized orbits are within normal limits.
Suprahyoid Neck: The oral cavity is within normal limits. No oropharyngeal mass is seen. The palatine tonsillar tissue is slightly prominent, likely reflecting a reactive process. Associated scattered dystrophic calcifications reflect sequelae of prior inflammation. No discrete or pharyngeal mass is seen. The parapharyngeal fat is unremarkable. The bilateral parotid and submandibular glands are within normal limits.
There is nonspecific skin thickening along the lower face, which is symmetric. No discrete drainable soft tissue fluid collection is seen.
Infrahyoid Neck: The hypopharynx, larynx, and proximal subglottic airway are unremarkable.
Thyroid: The thyroid is homogenous in appearance without focal nodule or mass.
Nodes: Underlying the palpable area of concern as denoted by the external marker, there is a prominent and rounded left level 1B node, which measures 1.5 x 1.2 cm and is without a preserved normal fatty hilum. Other slightly prominent suprahyoid lymph nodes are not pathologically enlarged and demonstrate preserved normal fatty hila.
Lung apices: The partially visualized lung apices are clear.
Vascular Structures: The partially visualized central vascular structures are normal in appearance.
Other findings: No aggressive or destructive osseous lesion is seen. Minimal degenerative changes of the cervical spine include a trace disc osteophyte complex at C5-C6 with minimal left uncovertebral hypertrophy.
Rounded and slightly enlarged left level 1B node with loss of normal fatty hila. While this may be reactive, continued attention on follow-up for consideration to tissue sampling may be warranted.
Electronically Signed By: Kathryn Dean on October 31, 2022 09:01 AM
Narrative
EXAM:
CT NECK SOFT TISSUES WITH IV CONTRAST
CLINICAL HISTORY:
submandibular swelling
TECHNIQUE:
Using a multi-detector CT, a helical acquisition of the neck from the skull base to the thoracic inlet was performed during intravenous contrast infusion. Omnipaque 300 was administered IV for the study with a saline push. The exam was performed at 0.625 mm collimation, and reconstructed at 2.5 mm thickness at 1.25 mm intervals. Coronal and sagittal reconstructions were also performed and reviewed.
COMPARISON:
None available.
FINDINGS:
Nasopharynx/Skull Base: The fat planes at the skull base and the soft tissues of the nasopharynx are unremarkable. There is rightward nasal septal deviation. Scattered polypoid mucosal thickening is noted in the paranasal sinuses. The mastoids and middle ear clefts are unremarkable. The partially visualized orbits are within normal limits.
Suprahyoid Neck: The oral cavity is within normal limits. No oropharyngeal mass is seen. The palatine tonsillar tissue is slightly prominent, likely reflecting a reactive process. Associated scattered dystrophic calcifications reflect sequelae of prior inflammation. No discrete or pharyngeal mass is seen. The parapharyngeal fat is unremarkable. The bilateral parotid and submandibular glands are within normal limits.
There is nonspecific skin thickening along the lower face, which is symmetric. No discrete drainable soft tissue fluid collection is seen.
Infrahyoid Neck: The hypopharynx, larynx, and proximal subglottic airway are unremarkable.
Thyroid: The thyroid is homogenous in appearance without focal nodule or mass.
Nodes: Underlying the palpable area of concern as denoted by the external marker, there is a prominent and rounded left level 1B node, which measures 1.5 x 1.2 cm and is without a preserved normal fatty hilum. Other slightly prominent suprahyoid lymph nodes are not pathologically enlarged and demonstrate preserved normal fatty hila.
Lung apices: The partially visualized lung apices are clear.
Vascular Structures: The partially visualized central vascular structures are normal in appearance.
Other findings: No aggressive or destructive osseous lesion is seen. Minimal degenerative changes of the cervical spine include a trace disc osteophyte complex at C5-C6 with minimal left uncovertebral hypertrophy.
Male | 42 years old
Medications: Lipitor 10 mg
Conditions: High Cholesterol
1 Answer
Depends on your history and risk factors. Things that would make me more worried: History of smoking or chewing tobacco use, HPV, prior history of cancer, it’s been there a long time and is growing. Things that would make me less worried: Recent vaccination, a recent upper respiratory infection. If you will sleep better at night you can get a fine needle biopsy. It is very easy. Done with local anesthesia. Takes about 30min. All that being said, it’s not very big.
