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Radiology.Academy.Sk

CT Neck Phlegmon

CT Neck with contrast: Routine transverse CT images from skull base to thoracic inlet after the IV administration of nonionic contrast.

Findings: There is extensive mucosal edema involving the oropharynx and hypopharynx. The inflammatory change extends into the retropharyngeal soft tissues where there are phlegmonous changes that extend to the level of C7-T1. There is no extension inferiorly into the mediastinum. There is no drainable fluid collection. There is diffuse thickening of the aryepiglottic folds and false vocal cords. There is no abnormality noted of the true cords. There is fatty inflammation of the left greater than right parapharyngeal fat. Inflammatory change extends into the carotid and parotid spaces bilaterally. There is mild symmetric narrowing of the supraglottic airway. There is a prominent retropharyngeal enhancing nodular mass that measures 4 mm in short axis, likely a reactive lymph node. Multiple additional prominent lymph nodes are noted throughout the cervical chains, not pathologically enlarged by size criteria. There is mild inflammatory change involving the proximal esophagus.
There is no aneurysm or filling defect of the vessels of the skull base or neck. The cervical spine demonstrates loss of the lordotic curvature without fracture or subluxation. The vertebral body heights and disc spaces are preserved without significant disc height loss or endplate degenerative change. There is no significant neuroforaminal or spinal canal stenosis.

Conclusion: Extensive pharyngeal mucosal space and retropharyngeal phlegmonous change with extension into the adjacent spaces of the neck as described above. There is diffuse swelling of the aryepiglottic fold and supraglottic soft tissues however the true cords are within normal limits. The retropharyngeal component extends to the C7-T1 level without definite mediastinal extension. No definite drainable collection is identified. ENT consultation is recommended.