Female, 37 years old, with a submucosal mass, approximately 1 cm in size, at the right tonsillar pillar/soft palate. The right palatine tonsil is mildly enlarged relative to the left, measuring up to 16 x 12 mm in the axial plane compared to 15 x 9 mm on the left. At the junction of the right palatine tonsil and soft palate, a 3 mm cystic focus is also identified (see image 35 series 901). The signal intensity of the right palatine tonsil on T1, T2 and diffusion-weighted images is identical to that seen on the left with the exception of the small cystic focus. The pattern of enhancement is also similar to that seen on the left.The aerodigestive mucosa is otherwise unremarkable. No evidence of pathologic adenopathy is detected in the neck. The salivary glands and the thyroid are free of focal lesions. The bone marrow signal characteristics are within normal limits.
Mild asymmetric enlargement of the right palatine tonsil is seen along with a 3 mm cystic focus at the junction of the tonsil with the soft palate. Otherwise, signal characteristics and pattern of enhancement of the right palatine tonsil are identical to those of the left.The differential diagnosis for these findings would include an asymmetrically reactive or inflamed tonsil. A neoplastic process is not excluded, though the lack of a discrete lesion, and lack of any differential enhancement or signal compared to the normal left tonsil, would argue against this possibility.