Female, 29 years old, with history of nasopharyngeal carcinoma status post treatment with chemotherapy and radiation. Asymmetry of the nasopharyngeal mucosa is again seen appearing similar to the prior examination and perhaps related to therapy. Likewise, a thin layer of T2 hyperintense material along the left aspect of the nasopharynx is also similar to prior and may simply represent adherent secretions. No evidence of any recurrent aerodigestive tumor is seen. No pathologic adenopathy is detected in the neck by size criteria. The glandular tissues are unremarkable. The bone marrow signal characteristics are within normal limits. A new focus of susceptibility is evident within the brainstem at the level of the obex (see image 17 series 8) which is present on all sequences and not likely to be artifactual. There does not appear to be any associated parenchymal edema or mass effect.
1.Treatment related findings in the neck with no evidence to suggest recurrent nasopharyngeal tumor or pathologic adenopathy.2.A small focus of susceptibility within the brainstem at the level of the obex is new when compared to prior examinations. This could represent chronic microhemorrhage of uncertain etiology. If clinical concern warrants, dedicated brain imaging can be obtained to better assess this lesion and to evaluate for the presence of additional lesions.