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What Does My CT Scan Report Indicate?
Question: Would like an interpretation of this CT report
Have had recurrent tonsillitis and am concerned with the superclavicular node. Could this be reactive to the abscess? Also what does necrotic mass mean in simpler terms?
INDICATION:SWELLING OF TONSIL
TECHNIQUE: Contrast CT of the neck performed from the skull base through the lung
apices with sagittal and coronal reformats.
CONTRAST: 100 cc of Isovue-300 intravenous contrast
Radiation dose:CTDI Vol (mGy):DLP (mGy-cm) 12.8, 435]
COMPARISON: None
FINDINGS:
Orbits/Paranasal Sinuses/Skull Base: Normal.
Nasopharynx: There is mild edema within the right nasopharynx this is best seen on
series 201 image 99 and image 104.
Oropharynx: Right tonsillar enlargement. There is a right intratonsillar well-defined
fluid collection measuring approximately 2.2 x 1.2 x 1.5 cm. There is peritonsillar
edema on the right extending into the right nasopharynx. Left tonsil is normal.
Larynx/Suprahyoid Neck: Aryepiglottic folds and vocal cords are symmetrical.
Infrahyoid Neck: The hypopharynx, trachea, and esophagus are normal.
Thyroid: No nodules are identified.
Thoracic Inlet: Lung apices are clear.
Lymph Nodes: Enlarged right jugulodigastric lymph nodes measuring 1.5 x 1.1 cm in
maximal dimension. Increased subcentimeter lymph nodes within the left jugulodigastric
lymph node chain, posterior triangle, likely reactive. Enlarged lymph node within the
right supraclavicular region measuring 1 cm.
Vascular Structures: There is no significant carotid stenosis.
Other Findings: None.
IMPRESSION:
Right tonsils is larger compared to left. There is a well-defined fluid collection
within the right tonsil measuring 2.2 cm, in a patient with recurrent tonsillitis this
is favored to represent an abscess. If there is persistent symptoms status post
treatment, tissue diagnosis is recommended as necrotic mass could have this is
appearance. Mild edema is seen within the right peritonsillar region extending into the
right nasopharynx.
Enlarged right jugulodigastric lymph node measuring 1.5 cm. Enlarged right
supraclavicular lymph node measuring 1.1 cm. There are also increased number of
subcentimeter lymph nodes within the bilateral neck, likely reactive.
Have had recurrent tonsillitis and am concerned with the superclavicular node. Could this be reactive to the abscess? Also what does necrotic mass mean in simpler terms?
INDICATION:SWELLING OF TONSIL
TECHNIQUE: Contrast CT of the neck performed from the skull base through the lung
apices with sagittal and coronal reformats.
CONTRAST: 100 cc of Isovue-300 intravenous contrast
Radiation dose:CTDI Vol (mGy):DLP (mGy-cm) 12.8, 435]
COMPARISON: None
FINDINGS:
Orbits/Paranasal Sinuses/Skull Base: Normal.
Nasopharynx: There is mild edema within the right nasopharynx this is best seen on
series 201 image 99 and image 104.
Oropharynx: Right tonsillar enlargement. There is a right intratonsillar well-defined
fluid collection measuring approximately 2.2 x 1.2 x 1.5 cm. There is peritonsillar
edema on the right extending into the right nasopharynx. Left tonsil is normal.
Larynx/Suprahyoid Neck: Aryepiglottic folds and vocal cords are symmetrical.
Infrahyoid Neck: The hypopharynx, trachea, and esophagus are normal.
Thyroid: No nodules are identified.
Thoracic Inlet: Lung apices are clear.
Lymph Nodes: Enlarged right jugulodigastric lymph nodes measuring 1.5 x 1.1 cm in
maximal dimension. Increased subcentimeter lymph nodes within the left jugulodigastric
lymph node chain, posterior triangle, likely reactive. Enlarged lymph node within the
right supraclavicular region measuring 1 cm.
Vascular Structures: There is no significant carotid stenosis.
Other Findings: None.
IMPRESSION:
Right tonsils is larger compared to left. There is a well-defined fluid collection
within the right tonsil measuring 2.2 cm, in a patient with recurrent tonsillitis this
is favored to represent an abscess. If there is persistent symptoms status post
treatment, tissue diagnosis is recommended as necrotic mass could have this is
appearance. Mild edema is seen within the right peritonsillar region extending into the
right nasopharynx.
Enlarged right jugulodigastric lymph node measuring 1.5 cm. Enlarged right
supraclavicular lymph node measuring 1.1 cm. There are also increased number of
subcentimeter lymph nodes within the bilateral neck, likely reactive.
Brief Answer:
Presence of pus around the right tonsil...
Detailed Answer:
Hi
Thanks for posting the query
I have gone through the details of your CT Scan report. It says, you are having pus collection around the right tonsil extending to the back of the nose. They have also suspected the dead tissue around the tonsil in the absence of pus.
Following infection of the tonsils or behind the nose, it is usually the julgulo-digastric nodes (the nodes behind the angle of the mandible) which gets enlarged and not the supraclavicular lymph node. Supraclavicular lymph nodes enlarge when there is infection or inflammation in the neck or upper part of the lungs.
You may require a course of antibiotic, followed by a small office procedure to drain out the pus around the tonsil.
Hope this answers your query; I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Presence of pus around the right tonsil...
Detailed Answer:
Hi
Thanks for posting the query
I have gone through the details of your CT Scan report. It says, you are having pus collection around the right tonsil extending to the back of the nose. They have also suspected the dead tissue around the tonsil in the absence of pus.
Following infection of the tonsils or behind the nose, it is usually the julgulo-digastric nodes (the nodes behind the angle of the mandible) which gets enlarged and not the supraclavicular lymph node. Supraclavicular lymph nodes enlarge when there is infection or inflammation in the neck or upper part of the lungs.
You may require a course of antibiotic, followed by a small office procedure to drain out the pus around the tonsil.
Hope this answers your query; I will be available for the follow-up queries.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Prasad
Had two follow ups, normal exam on one, small abscess on the other. Dr wants to wait for three weeks to review on Ct. if same Ct findings, wants tonsils out for cancer screen.
Should I wait that long? Is cancer indicated here?
Should I wait that long? Is cancer indicated here?
Brief Answer:
Please wait for the complete resolution to happen...
Detailed Answer:
Hi
Thanks for writing back and my sincere apologies for the delay.
1. Its a good news that the swelling has reduced. It implies, the collection over the tonsil has subsided.
2. I honestly feel, you should wait for the complete resolution of the inflammation and the collection over the tonsil. Later, you can get the CT scan done as advised by your doctor.
3. I doubt any cancer in this case. In the case of cancer, there will be a fleshy growth with occasional bleeding and excruciating pain.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Please wait for the complete resolution to happen...
Detailed Answer:
Hi
Thanks for writing back and my sincere apologies for the delay.
1. Its a good news that the swelling has reduced. It implies, the collection over the tonsil has subsided.
2. I honestly feel, you should wait for the complete resolution of the inflammation and the collection over the tonsil. Later, you can get the CT scan done as advised by your doctor.
3. I doubt any cancer in this case. In the case of cancer, there will be a fleshy growth with occasional bleeding and excruciating pain.
Hope this clarifies your doubts. Wish you good health.
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by :
Dr. Prasad
Would an ent who suspected cancer just immediately order the tonsils out then? I'm just curious as to why my symptoms seem to be coming and going.
Brief Answer:
Yes, if there is any doubt about malignancy the tonsil has to be removed...
Detailed Answer:
Hi
Thanks for writing back
Yes, definitely. If there is even an-iota of doubt about malignancy of the tonsils, excision biopsy has to be done. Secondly, the malignancy of the tonsils grows quickly as it is richly supplied with blood.
Your symptoms seem to be of recurrent/chronic tonsillitis, but definitely not a sign of malignancy.
Hope this answers your query
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Yes, if there is any doubt about malignancy the tonsil has to be removed...
Detailed Answer:
Hi
Thanks for writing back
Yes, definitely. If there is even an-iota of doubt about malignancy of the tonsils, excision biopsy has to be done. Secondly, the malignancy of the tonsils grows quickly as it is richly supplied with blood.
Your symptoms seem to be of recurrent/chronic tonsillitis, but definitely not a sign of malignancy.
Hope this answers your query
Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
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. Prasad
Answered by
Dr. Dr. Naveen Kumar Nanjasetty
Otolaryngologist / ENT Specialist
Practicing since :2001
Answered : 2542 Questions
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