What is Your Diagnosis

Malignant tumor: In smokers, malignant tumors of the face and neck are frequent (Fig. 13.25a). Often they are diagnosed by the patient or clinically before any abnormality can be verified with imaging modalities. This

Reasons For Asymmetry Mammography

I Malignant Tumor of the Head and Neck a

Reasons For Asymmetry Mammography

Fig.13.25a Contrast-enhanced axial T1-weighted MR imaging shows the approximate level of the vocal cords. The enhancing mass posterior to the airway causes an obvious asymmetry—an essential radiological observation in the complex head and neck area. This proved to be a carcinoma of the hypopharynx. b The enlargement and peripheral irregular contrast enhancement of a left sided regional lymph node (arrows) lateral to the signal void of the carotid artery on this T1-weighted image proves the regional lymphatic spread. For your orientation: in the middle of the image you see the airway; craniallyon both sides at a distance the relatively signal-free mandibular bone with the masseter muscle lateral and the pterygoid muscle medial to it.

by needle biopsy helps obtain a tissue diagnosis. If lymphoma is diagnosed, staging is best complemented by CT (Fig. 13.26b).

Cervical cysts: Congenital malformations such as lateral or median cervical cyst can cause swelling in the cervical region. The lateral cervical cysts or branchial cleft cysts (Fig. 13.27) are remnants of the embryonal set of gills. They are located lateral to the jugular vein and dorsal to the submandibular salivary gland. They often become clinically apparent when an acute inflammation develops inside. A fistulous connection of the cysts to the skin surface may form and prompt a search for the underlying etiology. Median cervical cysts originate from remnants of the thyroglossal duct, particularly at the base of the tongue. Clinically the tumor is soft and elastic and moves during swallowing.

Paraganglioma or glomus tumor: Any pulsatile mass of the neck is diagnosed and treated with special caution. A premature core needle biopsy may result in severe hemorrhage. Paragangliomas arise from extra-adrenal

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