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CT scan showed prominence of the adenoid soft tissues. Mucous-retention cyst. Sounds serious?

CT OF THE NECK WITH INTRAVENOUS CONTRAST - 06/21/12 HISTORY: Enlarged tonsils. TECHNIQUE: Axial computed tomography of the neck with intravenous contrast administration per standard protocol with coronal and sagittal reformatted images; 100 ml Optiray 350 intravenously at left antecubital fossa without incident. COMPARISON: None directly available. Findings: Motion artifact is noted in examination. The parotid glands and submandibular glands are unremarkable in appearance. The thyroid gland is largely unremarkable as imaged. There is mild prominence of the adenoid soft tissues, slightly more prominent than the left with minimal mass effect at the airway. This is best appreciated at axial image 30. Consider direct visualization as a mass is difficult to exclude. There is no definite evidence of fluid collection/abscesses in the neck. Of note, the patient s head is rotated toward the left and therefore this may cause an atypical appearance to the central airway. This must be correlated clinically, as again, a mass is difficult to exclude given this image appearance. The vascular structures are intact and unremarkable as imaged. There is no discrete lymphadenopathy within the neck although there are bilateral subcentimeter lymph nodes, nonspecific. The imaged paranasal sinuses and mastoid air cells are fairly well aerated. A mucous-retention cyst versus polyp is suspected at the inferior aspect if the left maxillary sinus . The osseous structures are intact. The lung apices are unremarkable. Impression: 1. Prominence of the adenoid soft tissues. There appears to be soft tissue prominence at the left aspect of the airway with some component of mass effect which could be associated with the patients head tilted toward the left. A mass is difficult to exclude given this imaging appearance and clinical correlation is requested. Direct visualization may be helpful if needed. 2. Nonspecific subcentimeter lymph nodes within the neck; no evidence of lymphadenopathy. 3. Mucous-retention cyst versus polyp at the inferior aspect of the left maxillary sinus.
Asked On : Wed, 27 Jun 2012
Answers:  1 Views:  561
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Radiologist 's  Response
From your report, it appears as though, the adenoid asymmetry is probably artefactual (due to the head being tilted). Adenoid enlargement is usually due to some infection, etc. and tumors in this region are uncommon. Also, a tumor (referred to as mass in your report) usually appears bright on contrast CT. Finally, your ENT surgeon can easily visualize this region on examination and can rule out a tumor.
The retention cyst or polyp in the maxillary sinus can be differentiated by doing CT scan in a different position (cyst will move). However, if you don't have any symptoms for sinusitis, there is no need for repeating the scan.
Overall, it doesn't appear as though you have anything to worry about. Just consult your local ENT specialist.
Answered: Fri, 19 Apr 2013
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