Wk 4, Case 40 - Review

REPORT
CLINICAL INDICATION: 27-year-old male with sore throat x3 days and bilateral tonsillar exudate on physical exam.

TECHNIQUE: Postcontrast CT images of the neck were obtained from the petrous apices down through the thoracic inlet after the intravenous administration of iodinated contrast.
COMPARISON: None.
FINDINGS:
The structures about the skull base are unremarkable. Orbits are grossly unremarkable. Mild mucosal thickening involving bilateral maxillary sinus and bilateral anterior ethmoid air cells. Mastoid air cells are clear.
The floor of mouth and base of tongue structures are within normal limits. The larynx is symmetric.
There is approximately 1.4 x 1.7 x 1.2 cm (TRV by AP by CC) hypodense collection adjacent to the left tonsil within the left parapharyngeal space compatible with a small abscess (Key Image 1). Tiny hypodensities are also noted within the left palatine tonsil which could represent small crypts versus extension of the abscess. Edema spreads to the supraglottic larynx and the piriform sinus on the left side.
The thyroid gland is symmetric and homogenous.
Mildly prominent bilateral cervical lymph nodes are evident, largest at the left level 2B station measuring up to 1.4 x 2.6 cm, likely reactive in etiology.
The superior mediastinum is unremarkable. The lung apices are clear. Visualized portions of the intracranial and neck vasculature appear unremarkable.
No evidence of acute fracture or focal lytic or blastic lesions. The patient has screws in the anterior mandible likely for prior fracture.
IMPRESSION:
Small 1.4 x 1.7 x 1.2 cm hypodense collection adjacent to the left tonsil within the left parapharyngeal space is compatible with a peritonsillar abscess. Reactive bilateral cervical lymphadenopathy.