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I Would Like To Have An ENT Explain This Report
Question: I would like to have an ENT explain this report to me.
Report
CT-SOFT TISSUE NECK POST IV CONTRAST
History: Right-sided neck mass/swelling. Recent ultrasound reportedly demonstrated a
right level IV lymph node measuring 3.2 cm
Technique: The patient was examined and a marker placed over the area of clinical
concern. Following the administration of 85cc of Omnipaque 350 intravenous contrast axial
images were obtained through the neck with sagittal, axial and coronal reformatted images
then generated from the axial acquired data. This study was performed using automatic
exposure control (radiation dose reduction software) to obtain a diagnostic image quality
scan with patient dose as low as reasonably achievable. One or more of the following dose
reduction techniques were used: Automated exposure control, Adjustment of the mA and/or
kV according to patient size or Use of iterative reconstruction technique. The
administered radiation dose was 1.9 mSv.
Renal function: Per ACR guidelines and Zwanger-Pesiri policy, a creatinine level was
performed prior to the examination. Results were as follows: Creatinine = 0.4 mg/dL.
Prior examinations: Ultrasound dated September 7, 2020.
Aerodigestive tract: No primary aerodigestive tract lesion is seen.
Lymph nodes: No pathologically enlarged lymph nodes are seen at the following locations:
-Right level III measuring 2.3 cm in craniocaudad dimension, 9 mm left-right dimension and
5.5 mm anterior-posterior dimension (see axial image #61 of series #7 and sagittal image
#46 of series #4).
-Right level IV lymph node that measures 3.4 cm in craniocaudad dimension, 1.7 cm
anterior-posterior-posterior dimension of 5.8 mm in left-right dimension (see sagittal
image #47 of series #4, axial image #309 of series #6 and coronal image #43 of series #3.
Multiple other lymph nodes are seen in the neck which are all less than 1 cm in diameter.
All lymph nodes are solid without necrosis or extracapsular spread of disease.
Parotid glands: The parotid glands have a normal size and enhancement pattern. No parotid
masses or ductal dilatation is seen. No radiopaque calculi are identified.
Submandibular glands: The submandibular glands have a normal size and enhancement
pattern. No submandibular gland masses or ductal dilatation is seen. No radiopaque calculi
are identified.
Thyroid gland: The thyroid gland is normal in size. There are no thyroid nodules.
Thoracic inlet: Normal.
Lung apices: Normal.
Brain: Limited evaluation of the brain parenchyma does not demonstrate any mass, mass
effect, edema, hemorrhage or infarct.
Orbits: No orbital masses are seen. The globes, extraocular muscles and lacrimal glands
are normal.
Paranasal sinuses: Normally developed and aerated.
Temporal bones: Normal.
Cervical and upper thoracic spine: Normal.
IMPRESSION:
Pathologically enlarged right level III and right level IV lymph nodes. Histologic
sampling is recommended if they need to be further characterized.
No primary aerodigestive tract lesion is seen.
Signed by: XXXXXXX Panasci MD
Signed Date: 10/6/2020 3:21 PM EDT
Report
CT-SOFT TISSUE NECK POST IV CONTRAST
History: Right-sided neck mass/swelling. Recent ultrasound reportedly demonstrated a
right level IV lymph node measuring 3.2 cm
Technique: The patient was examined and a marker placed over the area of clinical
concern. Following the administration of 85cc of Omnipaque 350 intravenous contrast axial
images were obtained through the neck with sagittal, axial and coronal reformatted images
then generated from the axial acquired data. This study was performed using automatic
exposure control (radiation dose reduction software) to obtain a diagnostic image quality
scan with patient dose as low as reasonably achievable. One or more of the following dose
reduction techniques were used: Automated exposure control, Adjustment of the mA and/or
kV according to patient size or Use of iterative reconstruction technique. The
administered radiation dose was 1.9 mSv.
Renal function: Per ACR guidelines and Zwanger-Pesiri policy, a creatinine level was
performed prior to the examination. Results were as follows: Creatinine = 0.4 mg/dL.
Prior examinations: Ultrasound dated September 7, 2020.
Aerodigestive tract: No primary aerodigestive tract lesion is seen.
Lymph nodes: No pathologically enlarged lymph nodes are seen at the following locations:
-Right level III measuring 2.3 cm in craniocaudad dimension, 9 mm left-right dimension and
5.5 mm anterior-posterior dimension (see axial image #61 of series #7 and sagittal image
#46 of series #4).
-Right level IV lymph node that measures 3.4 cm in craniocaudad dimension, 1.7 cm
anterior-posterior-posterior dimension of 5.8 mm in left-right dimension (see sagittal
image #47 of series #4, axial image #309 of series #6 and coronal image #43 of series #3.
Multiple other lymph nodes are seen in the neck which are all less than 1 cm in diameter.
All lymph nodes are solid without necrosis or extracapsular spread of disease.
Parotid glands: The parotid glands have a normal size and enhancement pattern. No parotid
masses or ductal dilatation is seen. No radiopaque calculi are identified.
Submandibular glands: The submandibular glands have a normal size and enhancement
pattern. No submandibular gland masses or ductal dilatation is seen. No radiopaque calculi
are identified.
Thyroid gland: The thyroid gland is normal in size. There are no thyroid nodules.
Thoracic inlet: Normal.
Lung apices: Normal.
Brain: Limited evaluation of the brain parenchyma does not demonstrate any mass, mass
effect, edema, hemorrhage or infarct.
Orbits: No orbital masses are seen. The globes, extraocular muscles and lacrimal glands
are normal.
Paranasal sinuses: Normally developed and aerated.
Temporal bones: Normal.
Cervical and upper thoracic spine: Normal.
IMPRESSION:
Pathologically enlarged right level III and right level IV lymph nodes. Histologic
sampling is recommended if they need to be further characterized.
No primary aerodigestive tract lesion is seen.
Signed by: XXXXXXX Panasci MD
Signed Date: 10/6/2020 3:21 PM EDT
I would like to have an ENT explain this report to me.
Report
CT-SOFT TISSUE NECK POST IV CONTRAST
History: Right-sided neck mass/swelling. Recent ultrasound reportedly demonstrated a
right level IV lymph node measuring 3.2 cm
Technique: The patient was examined and a marker placed over the area of clinical
concern. Following the administration of 85cc of Omnipaque 350 intravenous contrast axial
images were obtained through the neck with sagittal, axial and coronal reformatted images
then generated from the axial acquired data. This study was performed using automatic
exposure control (radiation dose reduction software) to obtain a diagnostic image quality
scan with patient dose as low as reasonably achievable. One or more of the following dose
reduction techniques were used: Automated exposure control, Adjustment of the mA and/or
kV according to patient size or Use of iterative reconstruction technique. The
administered radiation dose was 1.9 mSv.
Renal function: Per ACR guidelines and Zwanger-Pesiri policy, a creatinine level was
performed prior to the examination. Results were as follows: Creatinine = 0.4 mg/dL.
Prior examinations: Ultrasound dated September 7, 2020.
Aerodigestive tract: No primary aerodigestive tract lesion is seen.
Lymph nodes: No pathologically enlarged lymph nodes are seen at the following locations:
-Right level III measuring 2.3 cm in craniocaudad dimension, 9 mm left-right dimension and
5.5 mm anterior-posterior dimension (see axial image #61 of series #7 and sagittal image
#46 of series #4).
-Right level IV lymph node that measures 3.4 cm in craniocaudad dimension, 1.7 cm
anterior-posterior-posterior dimension of 5.8 mm in left-right dimension (see sagittal
image #47 of series #4, axial image #309 of series #6 and coronal image #43 of series #3.
Multiple other lymph nodes are seen in the neck which are all less than 1 cm in diameter.
All lymph nodes are solid without necrosis or extracapsular spread of disease.
Parotid glands: The parotid glands have a normal size and enhancement pattern. No parotid
masses or ductal dilatation is seen. No radiopaque calculi are identified.
Submandibular glands: The submandibular glands have a normal size and enhancement
pattern. No submandibular gland masses or ductal dilatation is seen. No radiopaque calculi
are identified.
Thyroid gland: The thyroid gland is normal in size. There are no thyroid nodules.
Thoracic inlet: Normal.
Lung apices: Normal.
Brain: Limited evaluation of the brain parenchyma does not demonstrate any mass, mass
effect, edema, hemorrhage or infarct.
Orbits: No orbital masses are seen. The globes, extraocular muscles and lacrimal glands
are normal.
Paranasal sinuses: Normally developed and aerated.
Temporal bones: Normal.
Cervical and upper thoracic spine: Normal.
IMPRESSION:
Pathologically enlarged right level III and right level IV lymph nodes. Histologic
sampling is recommended if they need to be further characterized.
No primary aerodigestive tract lesion is seen.
Signed by: XXXXXXX Panasci MD
Signed Date: 10/6/2020 3:21 PM EDT
Report
CT-SOFT TISSUE NECK POST IV CONTRAST
History: Right-sided neck mass/swelling. Recent ultrasound reportedly demonstrated a
right level IV lymph node measuring 3.2 cm
Technique: The patient was examined and a marker placed over the area of clinical
concern. Following the administration of 85cc of Omnipaque 350 intravenous contrast axial
images were obtained through the neck with sagittal, axial and coronal reformatted images
then generated from the axial acquired data. This study was performed using automatic
exposure control (radiation dose reduction software) to obtain a diagnostic image quality
scan with patient dose as low as reasonably achievable. One or more of the following dose
reduction techniques were used: Automated exposure control, Adjustment of the mA and/or
kV according to patient size or Use of iterative reconstruction technique. The
administered radiation dose was 1.9 mSv.
Renal function: Per ACR guidelines and Zwanger-Pesiri policy, a creatinine level was
performed prior to the examination. Results were as follows: Creatinine = 0.4 mg/dL.
Prior examinations: Ultrasound dated September 7, 2020.
Aerodigestive tract: No primary aerodigestive tract lesion is seen.
Lymph nodes: No pathologically enlarged lymph nodes are seen at the following locations:
-Right level III measuring 2.3 cm in craniocaudad dimension, 9 mm left-right dimension and
5.5 mm anterior-posterior dimension (see axial image #61 of series #7 and sagittal image
#46 of series #4).
-Right level IV lymph node that measures 3.4 cm in craniocaudad dimension, 1.7 cm
anterior-posterior-posterior dimension of 5.8 mm in left-right dimension (see sagittal
image #47 of series #4, axial image #309 of series #6 and coronal image #43 of series #3.
Multiple other lymph nodes are seen in the neck which are all less than 1 cm in diameter.
All lymph nodes are solid without necrosis or extracapsular spread of disease.
Parotid glands: The parotid glands have a normal size and enhancement pattern. No parotid
masses or ductal dilatation is seen. No radiopaque calculi are identified.
Submandibular glands: The submandibular glands have a normal size and enhancement
pattern. No submandibular gland masses or ductal dilatation is seen. No radiopaque calculi
are identified.
Thyroid gland: The thyroid gland is normal in size. There are no thyroid nodules.
Thoracic inlet: Normal.
Lung apices: Normal.
Brain: Limited evaluation of the brain parenchyma does not demonstrate any mass, mass
effect, edema, hemorrhage or infarct.
Orbits: No orbital masses are seen. The globes, extraocular muscles and lacrimal glands
are normal.
Paranasal sinuses: Normally developed and aerated.
Temporal bones: Normal.
Cervical and upper thoracic spine: Normal.
IMPRESSION:
Pathologically enlarged right level III and right level IV lymph nodes. Histologic
sampling is recommended if they need to be further characterized.
No primary aerodigestive tract lesion is seen.
Signed by: XXXXXXX Panasci MD
Signed Date: 10/6/2020 3:21 PM EDT
Brief Answer:
Hii. Welcome to the healthcare services. It seems that you are having enlar
Detailed Answer:
Hii. Welcome to the healthcare services. It seems that you are having enlarged lymph nodes in the neck at level III and IV. Are you having any symptoms like fever, throat pain, difficulty in swallowing, change in voice, breathing difficulty, cough, nose discharge and bleeding? Others structures in the neck are looking normal according to CT scan report. Only two levels of lymph node is enlarged. This enlarged lymph nodes can be generally due to any viral or bacterial infection. So start an antibiotic tab augmentin 1 gm twice daily for 1 week. If the lymph nodes resolve then you don't need to do anything further. If the lymph node still persist then you can repeat an ultrasound and get a Fine needle aspiration cytology ( FNAC) of the lymph node done. If the biopsy came as inflammatory then no need to worry. If report comes as tuberculosis then anti tubercular treatment need to be started. If report comes out to be any other disease then it can be treated accordingly. So start an antibiotic and wait for 1-2 week. Then undergo a FNAC and review with the report.
Hii. Welcome to the healthcare services. It seems that you are having enlar
Detailed Answer:
Hii. Welcome to the healthcare services. It seems that you are having enlarged lymph nodes in the neck at level III and IV. Are you having any symptoms like fever, throat pain, difficulty in swallowing, change in voice, breathing difficulty, cough, nose discharge and bleeding? Others structures in the neck are looking normal according to CT scan report. Only two levels of lymph node is enlarged. This enlarged lymph nodes can be generally due to any viral or bacterial infection. So start an antibiotic tab augmentin 1 gm twice daily for 1 week. If the lymph nodes resolve then you don't need to do anything further. If the lymph node still persist then you can repeat an ultrasound and get a Fine needle aspiration cytology ( FNAC) of the lymph node done. If the biopsy came as inflammatory then no need to worry. If report comes as tuberculosis then anti tubercular treatment need to be started. If report comes out to be any other disease then it can be treated accordingly. So start an antibiotic and wait for 1-2 week. Then undergo a FNAC and review with the report.
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
Hii. Welcome to the healthcare services. It seems that you are having enlar
Detailed Answer:
Hii. Welcome to the healthcare services. It seems that you are having enlarged lymph nodes in the neck at level III and IV. Are you having any symptoms like fever, throat pain, difficulty in swallowing, change in voice, breathing difficulty, cough, nose discharge and bleeding? Others structures in the neck are looking normal according to CT scan report. Only two levels of lymph node is enlarged. This enlarged lymph nodes can be generally due to any viral or bacterial infection. So start an antibiotic tab augmentin 1 gm twice daily for 1 week. If the lymph nodes resolve then you don't need to do anything further. If the lymph node still persist then you can repeat an ultrasound and get a Fine needle aspiration cytology ( FNAC) of the lymph node done. If the biopsy came as inflammatory then no need to worry. If report comes as tuberculosis then anti tubercular treatment need to be started. If report comes out to be any other disease then it can be treated accordingly. So start an antibiotic and wait for 1-2 week. Then undergo a FNAC and review with the report.
Hii. Welcome to the healthcare services. It seems that you are having enlar
Detailed Answer:
Hii. Welcome to the healthcare services. It seems that you are having enlarged lymph nodes in the neck at level III and IV. Are you having any symptoms like fever, throat pain, difficulty in swallowing, change in voice, breathing difficulty, cough, nose discharge and bleeding? Others structures in the neck are looking normal according to CT scan report. Only two levels of lymph node is enlarged. This enlarged lymph nodes can be generally due to any viral or bacterial infection. So start an antibiotic tab augmentin 1 gm twice daily for 1 week. If the lymph nodes resolve then you don't need to do anything further. If the lymph node still persist then you can repeat an ultrasound and get a Fine needle aspiration cytology ( FNAC) of the lymph node done. If the biopsy came as inflammatory then no need to worry. If report comes as tuberculosis then anti tubercular treatment need to be started. If report comes out to be any other disease then it can be treated accordingly. So start an antibiotic and wait for 1-2 week. Then undergo a FNAC and review with the report.
Above answer was peer-reviewed by :
Dr. Kampana
Hi. Thank you for responding. I was already put on amoxicillin-clav 875-125mg 2x a day. I just finished them on October 4th and the CT Scan done today October 6th. I have no symptoms at all. I quit smoking exactly 4 weeks ago. I was a smoker for 18 years. In your opinion, can this be cancerous? Can the scan tell if it is cancer? Please help, because I suffer from very bad anxiety. Thank you.
Hi. Thank you for responding. I was already put on amoxicillin-clav 875-125mg 2x a day. I just finished them on October 4th and the CT Scan done today October 6th. I have no symptoms at all. I quit smoking exactly 4 weeks ago. I was a smoker for 18 years. In your opinion, can this be cancerous? Can the scan tell if it is cancer? Please help, because I suffer from very bad anxiety. Thank you.
Brief Answer:
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC
Detailed Answer:
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC from the lymph node and sent to laboratory. I don't think it is cancerous. It can be tuberculosis, inflammatory or any granulomatous disease. So do a FNAC and review with the report.
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC
Detailed Answer:
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC from the lymph node and sent to laboratory. I don't think it is cancerous. It can be tuberculosis, inflammatory or any granulomatous disease. So do a FNAC and review with the report.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Brief Answer:
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC
Detailed Answer:
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC from the lymph node and sent to laboratory. I don't think it is cancerous. It can be tuberculosis, inflammatory or any granulomatous disease. So do a FNAC and review with the report.
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC
Detailed Answer:
Hii. CT scan doesn't show if the lymph nodes is cancerous or not. Do a FNAC from the lymph node and sent to laboratory. I don't think it is cancerous. It can be tuberculosis, inflammatory or any granulomatous disease. So do a FNAC and review with the report.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Would the radiologist have stated abnormal characteristics of the enlarged lymph nodes besides the size. For example, my ultrasound stated that the level 4 lymph node was missing the cental fatty hilum which is not stated on the CT Scan.
Would the radiologist have stated abnormal characteristics of the enlarged lymph nodes besides the size. For example, my ultrasound stated that the level 4 lymph node was missing the cental fatty hilum which is not stated on the CT Scan.
Brief Answer:
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagno
Detailed Answer:
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagnosis. If it is inflammatory then lymph node swelling disappear with antibiotic. The best diagnosis is through FNAC or excision biopsy. if swelling doesn't resolve with antibiotic then we need a FNAC or excision biopsy.
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagno
Detailed Answer:
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagnosis. If it is inflammatory then lymph node swelling disappear with antibiotic. The best diagnosis is through FNAC or excision biopsy. if swelling doesn't resolve with antibiotic then we need a FNAC or excision biopsy.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Brief Answer:
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagno
Detailed Answer:
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagnosis. If it is inflammatory then lymph node swelling disappear with antibiotic. The best diagnosis is through FNAC or excision biopsy. if swelling doesn't resolve with antibiotic then we need a FNAC or excision biopsy.
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagno
Detailed Answer:
Hii. We shouldn't confirm the diagnosis on the basis of radiologicak diagnosis. If it is inflammatory then lymph node swelling disappear with antibiotic. The best diagnosis is through FNAC or excision biopsy. if swelling doesn't resolve with antibiotic then we need a FNAC or excision biopsy.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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