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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Could Cervical Lymph Nodes In The Report Suggest?

A CT Soft tissue Neck with and without contrast CT Head with and without contrast recently yielded the following: There are small bilateral cervical lymph nodes, the largest in the right sublingual space measuring 7 mm x 4 mm Diffuse heterogeneous sclerotic change of the left mandible. Stable focus of greater increased sclerosis in the left mandible measuring 11 mm 5 mm. This is likely sequela of the patient s history of osteomyelitis. I read about a triangle of concern and also about Ludwig s Angina. Since I feel pressure around my throat and have had problems swallowing, I am wondering if this is actually Ludwig s Angina?My left neck is quite swollen and I feel somewhat breathless over the last 2 days. My head feels as though it is swollen and pounding constantly. I have a horrible throbbing on the back side of the head that NEVER STOPS! I have been to the ER about 20 x and to about 40 different doctors before I finally saw them write Osteomyelitis (history) on this report! (I have been suffering for 14 years)
Mon, 15 Dec 2014
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Radiologist,  's  Response
A lymph node of this size in sublingual space is not significant. However, if there are too many nodes (number not mentioned) this finding requires evaluation. FNAC of any of the accessible node may be done in view of the symptoms. Common causes of cervical nodes such as caries teeth, sinus infection or dandruff should be looked into.
Ludwig's angina is very painful condition but it is usually acute and unlikely to be present for so long.
Mandibular sclerosis may be due to chronic osteomyelitis provided there is a history. It can also happen due to fibrous dysplasia or paget's disease depending on your age (not mentioned). Both are benign conditions and does not cause pain usually.
Throbbing pain in head has numerous causes. Most common would hypertension or cardiac issue. But probably hypertension is not the cause since in so many visits, it should have been picked up. Sometimes extreme stress may cause such finding. I do not have enough information on your headache. Please get a neurology consult.
Have a nice day!
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What Could Cervical Lymph Nodes In The Report Suggest?

A lymph node of this size in sublingual space is not significant. However, if there are too many nodes (number not mentioned) this finding requires evaluation. FNAC of any of the accessible node may be done in view of the symptoms. Common causes of cervical nodes such as caries teeth, sinus infection or dandruff should be looked into. Ludwig s angina is very painful condition but it is usually acute and unlikely to be present for so long. Mandibular sclerosis may be due to chronic osteomyelitis provided there is a history. It can also happen due to fibrous dysplasia or paget s disease depending on your age (not mentioned). Both are benign conditions and does not cause pain usually. Throbbing pain in head has numerous causes. Most common would hypertension or cardiac issue. But probably hypertension is not the cause since in so many visits, it should have been picked up. Sometimes extreme stress may cause such finding. I do not have enough information on your headache. Please get a neurology consult. Have a nice day!