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Have had Head CT Scan for enlarged lymph node on neck. Findings?

May 2014
User rating for this question
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Answered by

Practicing since : 2002
Answered : 6316 Questions
I would like a detailed analysis of a Head CT Scan performed today which I can upload. In response to an enlarged potential lymph node or mass on the right side of my neck (LEVEL 5) - 2".
Posted Wed, 18 Sep 2013 in X-ray, Lab tests and Scans
Answered by Dr. Vivek Chail 21 hours later
Brief Answer:
Please upload jpeg images or allow more time

Detailed Answer:
Hi XXXXXXX kung,
Thanks for writing in to us.

Your request is important to us and I am Dr.Vivek, Radiologist with 10 years experience in CT scan imaging, replying to your query.

The file uploaded by you on dropbox is 59mb and I am unable to download it at the moment due to connectivity issues, within the stipulated time allowed to close this reply. This website encourages uploading jpeg images with your query, however, I will try my best to download the larger files through the link provided.

As it is compulsory to close a reply to any query within an hour of opening it at WWW.WWWW.WW I request you to allow me some more time for doing that.

I will attempt to download using a high bandwidth from another source in a few hours time and request you to send in another query reminder around 06 00 HRS GMT, the reason being I will not be able to contact you in any other way unless you send in another query in response to this one as per e health care policy.

Alternatively you can change format of images from DICOM to JPEG format and attach report and images (ten files at a time) with your query. I will get reply to your next query as soon as I am through with your scan and results.

Should you need any further help, please do not hesitate to contact the customer care team.

Dr Vivek
Above answer was peer-reviewed by
Follow-up: Have had Head CT Scan for enlarged lymph node on neck. Findings? 1 hour later
I included the dropbox link to download all
Answered by Dr. Vivek Chail 11 hours later
Brief Answer:
Neck level 5 right lymph nodes 7 to 8 in number

Detailed Answer:
Hi XXXXXXX kung,
Thanks for writing in to us.

I have downloaded your images from dropbox and gone through the series.

On CT scan neck contrast sequence; there are discrete level V lymph nodes on the right side of your neck. There are at least 7 to 8 lymph nodes. The largest lymph node measures 17 x 12 mm in size and shows moderate uptake of contrast. No necrosis seen within the lymph nodes. No matting is observed. Dental artifacts are also noted which are not significant.

In this situation it becomes important to discuss the duration since when you have appreciated the swelling on your neck and if you have experienced any acute symptoms like pain, fever, infections or any chronic features like significant loss of weight or have any associated sores in your head and neck region including mouth.

The first and most worrisome diagnosis in a 39 years old person as you would be to rule out any malignancy. A history of alcohol and/or tobacco use should strengthen the clinician’s suspicion. Lucent changes within nodes, size larger than 1.5cm, and loss of sharpness of nodal borders are often signs of metastatic carcinoma. But this is not in your case so we have to think of other causes as well. Malignant condition associated with lymph nodes must also be ruled out. Your complete blood examination and investigations like chest X XXXXXXX and ultrasound scan abdomen are necessary. Tests like lymph node FNAC or biopsy might also need to be done.

Infections or blood abnormalities must be discussed in detail with your doctor. The presentation with marked tenderness, torticollis, trismus and dysphagia with systemic signs of infection is seldom a diagnostic challenge to the clinician and the source of the reactive lymphadenopathy is usually easily identified. Initial treatment with directed antibiotic therapy and follow up is the rule.

Hope this answers your query.
Do write back in case of doubts.

Dr Vivek
Above answer was peer-reviewed by
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