Dr. Basuki Nath Bhagat
Family Physician
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,
How are you? I have asked you a question in the past, and you were kind and thorough. So here is another question, it is a general one. If any of these tests were done, would they show the lymph nodes of the neck? Perhaps as an incidental finding?
I tried to ask a radiologist, but my answer was from an internist. I do not think he understood my question. Please help me.
Hello,
Glad to have you back!
I am here to help you get the best medical advice.
I understand your concern. I am good. How are you? You asked which imaging tests would show the lymph nodes of the neck. Among the given options, CT (computed tomography) neck and MRI (magnetic resonance imaging) neck are the best answers. Because of the intrinsic high soft-tissue discrimination, MRI has become the preferred method for evaluating the soft tissues of the head and neck recently. CT neck is also effective in localizing any swelling of the lymph node or lymphadenopathy.
What are the findings of the above tests? Do you have any swelling in the neck area? Follow up with reports and symptoms if you are having any, and I will try my best to guide you.
Looking forward to your response in order to help you.
Thank you.
Patient's Query
Hello doctor,
Thank you for the reply.
Happy to hear you are well. I have had all the above-mentioned tests for another issue. I have a small inflamed tonsillar lymph node, which has been that way for a very long time. I just wondered if any of the tests I mentioned would have visualized the node because they focused on the brain and cervical spine, not the neck (soft tissue). The only specific neck and not cervical spine was the MRI with contrast, which would have visualized the arteries. No nodes were mentioned in any of the tests. Would it have been an incidental finding?
Hi,
Welcome back to icliniq.com.
So, basically, you had tests related to the brain and cervical spine. The only specific test related to the neck was the MRI Neck with contrast to visualize neck blood vessels. The cervical spine CT scan is also known as a neck CT scan. Soft tissues of the neck encompass all structures of the neck, including the cervical spine and lymph nodes in the cervical region or neck area. You had a cervical spine test, which means the results would have mentioned lymph nodes in the neck region along with the cervical spine status. The absence of any mention of nodes in any of the tests indicates that they are normal, and there is no need to highlight them in the impression or final report.
Yes, it may be an incidental finding of an inflamed tonsillar node, but is it physically palpable? How did you become aware of the inflamed tonsil node? Anyway, nothing to worry about because they did not show up in the CT cervical spine (neck), which means they are normal in size and not enlarged. Are you okay? I am asking because you had brain and cervical spine tests done, and I wonder if you experienced stroke-like symptoms that led to these tests. Just worried for you. You can take a chat consultation to discuss it.
I hope this has helped you.
Thank you.
Patient's Query
Hi doctor,
Thank you again for your time; I greatly appreciate it.
I have had severe facial and back-of-head pain at times. I also experience facial flushing. For several years, I have had a palpable small node in my neck, and I have always wondered about it. I have also had an elevated sedimentation rate, which they said was meaningless. I had previously written to you about my elevated ALP, which persisted, so they sent me to a liver specialist. They concluded that I have an elevated ALP because I fall outside of normal guidelines. Initially, they thought my face or head pain was due to a sinus infection, then considered trigeminal neuralgia, dystonia, cluster headaches, Eagle syndrome, and now occipital neuralgia. My cervical spine is a mess, but given my age, I feel like it comes from my neck, though they do not agree.
I get Botox for my face and lidocaine for my occipital area. I am not sure if it really helps, but I have learned to live with it. I also have a persistently curious, very low A1C with normal blood sugars. One doctor finds it curious; another says it is meaningless. I think it is from iron supplements. I am a vegan, and I thought maybe I was deficient in nutrients, so I increased my plant protein and others. So, I was just wondering about the MRI, CT, or MRA (magnetic resonance angiography). I thought an MRI or CT of the cervical spine was different from a neck MRI or CT, so it is good to know it is the same. I also thought it would show up on the brain MRI as it is not far from my ear. I tried phoning the radiologist, but they do not take patient calls.
Hi,
Welcome back to icliniq.com.
I am in the hospital and busy with the patients. I am going to reply to you after an hour. Sorry for the delay.
Thank you.
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Family Physician
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