Newly diagnosed left tonsil cancer, scanning per protocol 14-0905. There are enlarged and partly necrotic appearing left cervical lymph nodes with irregular and infiltrative margins suggestive of extracapsular extension. For example, a left level 2A lymph node measures 17 x 24 mm in axial section and a level 2B lymph node measures 17 x 25 mm, with invasion of the deep lobe of the parotid gland. There is no significant right cervical lymphadenopathy. There is mild asymmetric prominence and heterogeneity of the left palatine tonsil. The right parotid and bilateral submandibular glands are unremarkable. There are secretions in the right sphenoid sinus. There is also a small right maxillary sinus retention cyst. The orbits and imaged intracranial structures are unremarkable.
1. Metastatic left suprahyoid lymph node metastases with signs of extracapsular extension.2. Mild asymmetric prominence and heterogeneity of the left palatine tonsil may correspond to the known squamous cell carcinoma. 