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CT Neck Postop mandible, MM

TECHNIQUE: Helical CT images from the skullbase through the thoracic inlet after the administration of IV contrast were obtained. 2.5 mm axial reconstructions as well as coronal and sagittal reformations were provided. FINDINGS: There is an osseous defect in the right mandibular body with associated surrounding postsurgical change consistent with recent history of jaw surgery. There is inflammatory change with fat stranding in the surrounding soft tissues (image 24 through 45 of series 3). There is a small focus of air at the osseous defect. There is no focal fluid collection or evidence to suggest abscess formation. There are no pathologically enlarged lymph nodes. There is normal vascular enhancement seen. The paranasal sinuses, orbits, nasopharynx, oropharynx are normal. The salivary glands, parotid glands, and submandibular glands, are normal. The larynx, hypopharynx, and thyroid gland are normal. The visualized portions of the brain and the posterior fossa are normal. There is mild degenerative disc disease of the lower cervical spine. There are multiple lytic lesions seen throughout the osseous structures, compatible with history of multiple myeloma. There is no acute bony abnormality visualized. There is a right posterior upper lobe airspace opacity, which may represent dependent atelectasis, however a pneumonia is not excluded. IMPRESSION: 1. Postsurgical change at the left mandibular body with associated inflammatory changes, which may be expected given recent surgical history, however alternatively this may represent developing infection. No drainable fluid collection or evidence of abscess formation. 2. Right upper lobe airspace disease, may represent atelectasis however a pneumonia is not excluded. Consider obtaining dedicated PA and lateral views of the chest if clinically warranted. 3. Multiple lytic osseous lesions compatible with history of multiple myeloma.