Name of the Patient : Abc Xyza Anand Dadlmn / M / 32 yrs.
Referred by : Dr. Abc Xyz. Pradhan.
Examination : M.R.I. of the Brain and Paranasal Sinuses.
CLINICAL PROFILE :
H/O right lateral rhinotomy done on 00.00.00.
Median maxillectomy - HP - malignant teratoma. Received radiotherapy/chemotherapy.
Now C/O swelling on the right side of neck.
M.R.I of the brain and paranasal sinuses was performed using the following parameters :
5 mm thick T1 Weighted and T2 Weighted axial images.
5 mm thick T1 Weighted and FLAIR coronal images.
5 mm thick T1 Weighted sagittal images.
There is evidence of surgical intervention in the nasal cavity and paranasal sinuses. The right maxillary antrum, ethmoidal air cells bilaterally, right frontal sinus, sphenoid sinus and the nasal cavity on the right appear incommunication, the sequelae of previous surgery. The nasal septum is partially visualized in the midline.
There is evidence of soft tissue lining the left maxillary antrum, left frontal sinus and the sphenoid sinus and the lateral and inferior walls of the right maxillary antrum which most likely is inflammatory soft tissue. The left middle and inferior nasal turbinates and the left osteomeatal complex are well identified.
There is seen an approximately 2.3 cms diameter sized well-marginated mass lesion in the right submandibular region along the posterior margin of the right submandibular gland. This lesion is nearly isointense to normal muscle on the T1 Weighted images but appears hyperintense on the T2 Weighted and Flair images and most likely represents an enlarged lymph node. Resultant mild indentation on the right carotid sheath is noted.
The cribriform plate of ethmoid bone is not well-defined, (? eroded) (scan 101.9).
There is no focal area of altered signal intensity in the brain parenchyma per se.
Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
The clivus and the C1 and C2 vertebrae show fatty marrow changes the sequelae of previous surgery.
1. Post-operative/post-radiotherapy/post-chemotherapy status.
2. Soft tissue in the paranasal sinuses as described is most likely inflammatory mucosal thickening. (It is difficult to exclude a recurrent/residual mucosal neoplasm).
3. An approximately 2.3 cms diameter sized lesion in the right submandibular region is most likely an enlarged lymph node, probably metastatic in the given clinical setting.
4. No abnormality is detected within the brain parenchyma per se.
No pre-operative scan was available for review/comparison.