Dr. Chitrangada Jitendra
Radiology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Kindly give a report of my CT scan. I had CT scan for swollen lymph node in the left neck, posterior cervical.
Hello,
Welcome to icliniq.com.
Please find the CT scan report as below (attachment removed to protect patient identity).
Contrast enhanced CT neck,
• Bilateral neck spaces appear normal.
• Visualized neck vessels appear normal in course and caliber.
• Thyroid, submandibular and parotid glands appear normal.
• Few enlarged reactive lymph nodes with intact fatty hilum (hilum is a the portion of a lymph node where the efferent vessels exit) are seen in left sub-mental and jugular region.
• Visualized bones appear normal.
• Visualized lung fields appear normal.
Incidental note is made of a simple renal cyst in the upper pole of left kidney. If any further doubts please feel free to discuss.
Patient's Query
Thank you doctor,
I suppose your report should give me peace of mind. But it is not easy to achieve it. So please excuse my additional questions and they in no way mean to underestimate your findings, instead have to do with my anxiety.
1. I want to double check if you are 100 % certain that the hilum is intact in all these nodes, especially the swollen one. The ultrasound report had said hilum not clearly identified.
2. Are you able to measure the swollen one? Which other nodes are swollen?
3. I feel some discomfort in swallowing and minor ear pressure. It feels like something is wrong with my throat. Could the images tell you what it may be?
4. Are you able to speculate on the possibility why these nodes are swollen through the images?
Hello,
Welcome back to icliniq.com.
A) The lymph nodes have a fatty hilum which appears slightly dark on plain scans and is intact in your scan. Also, the shape of the enlarged and small nodes is oval and indicates benign enlargement secondary to foci of infection (small as scalp dandruff). On ultrasound sometimes the hilum is not differentiable from the rest of the node that is why CT is used.
B) I am unable to measure the swollen lymph node, but it would be approximately less than 1.5 cm in short axis diameter.
C) The other reactive lymph nodes are less than a centimeter and are in level II (jugular) on the left around the neck vessels.
D) Discomfort in swallowing and reactive lymph nodes can be concerning for tonsillitis. You can consult an ENT physician for the same, or even your general physician can check them. I hope this answers your questions.
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Radiology
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