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What Does My Ultrasound Test Result Indicate?

Posted on Wed, 15 Jun 2016

Question: Hi. I have had a neck swelling left side under jaw for the last 6 months. The last ultrasound and CT showed nothing out of the ordinary but the swelling continued and is now very painful (pain started in last two weeks). Further ultrasound today showed "small amount of fluid between the left submandibular and parotid glands which may reflect inflammatory change. It's nature and source is unknown. No enlarge lymph nodes detected. Left submandibular region shows a few small lymph nodes with echogenic hill and no suspicious features. Please can you let me know what I should do from here? My neck is very very painful and the swelling on one side is so noticeable. It's difficult to now sleep on that side. What should I now be asking for? Another scan? Bloods? I don't know. Thank you in advance.

Answered by Dr. Dr. Muhammad Sareer Khalil (1 hour later)

Brief Answer:
Explained

Detailed Answer:
Hello and welcome

I appreciate your concern

Based on the description, lymph node biopsy of one of the involved adjacent glands should be suggested to rule out malignancy.

If the excisional lymph node biopsy is negative for any malignant process then you can relax.

The CT was most likely done to see for any secondaries / widespread metastases. X ray chest , ESR , serum Calcium and ACE levels can be done to look for possible sarcoidosis.

let me know if you have any query

Please consult your doctor before taking any further course of action

Wishing you best of health

Thanks

Dr M.S Khalil

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. Muhammad Sareer Khalil (47 minutes later)

Thank you for your reply.

Can you tell me what indicates the need for a lymph node biopsy? Were the lymph nodes okay, I wasn't sure if they should have been in the area mentioned or not?

Also, what could the fluid be? The ultrasound technician actually called the doctor into the room as she was puzzled by the fluid. He said "it must be coming from somewhere" but he couldn't see the origin.

Any further information you could give me would be helpful. Do you think this sounds something sinister? All I know is that this swelling on my neck has not gone away and is now very painful and is VERY noticeable.

Thank you again for your help!

Answered by Dr. Dr. Muhammad Sareer Khalil (12 hours later)

Brief Answer:
Explained

Detailed Answer:
Hello again.

As I explained in the previous answer, the node biopsy is mainly to exclude a malignant disorder.

The fluid can be an exudate associated with submandibular and parotid inflammation. Though examination and cytology would be required.

The biopsy would confirm or rule out if its something sinister. Fungal and tuberculous infection can also present similarly.

let me know if you have any query

Please consult your doctor before taking any further course of action

Wishing you best of health

Thanks

Dr M.S Khalil

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. Chakravarthy Mazumdar