history of parotid lymphoma 20 years ago. Status post surgery/RT. Evaluate for recurrence. Also with METs to left hip, left arm and right leg. CT of the soft tissues of the neck.Images through the skull base and including cavernous sinuses, paranasal sinuses remain within normal limits. Opacification of mastoid air cells on the left may represent otitis and or secondary to prior prior treatment and compromise of the eustachian tube. There is a focal defect within the left jugular bulb with no enhancement which may represent a clot. The left internal jugular vein is not visualized and presumed occluded. Left carotid is patent. Within the soft tissues of the neck on the left side a large cluster of irregular calcification is noted immediately adjacent to the vertebral column which extends from the level of C1 inferiorly to approximately C3 -- C4 intervertebral disk level. This is not associated with any definitive soft tissue mass or enhancement. I am not certain of the etiology of this finding. However the above finding may represent calcification within a treated tumor, dystrophic calcification or embolic material. This finding is not within the parotid region and the left parotid gland is believed to have been surgically removed. No definitive evidence of a mass or pathologic adenopathy in the neck is detected. A left paramedian submental node measures 9 mm times 14-mm in transaxial dimension (axial image 47). Limited images of the apices of the lungs demonstrates no metastatic lesion please review the dictated report of CT of chest performed the same date. No definitive mediastinal abnormality. Bony density of the area of exam is negative for metastatic lesions.An MRI examination of soft tissues of the neck is recommended for better evaluation of areas of calcification and in particular to exclude the possibility of an associated soft tissue mass. Extensive degenerative changes of cervical spine with multilevel neural foramina compromise is noted.If there are outside studies available comparison will be made and if necessary an addendum will be added.CT of brain with infusion.No evidence of metastatic disease to the brain, leptomeninges or the calvarium is detected. Examination however demonstrates minimal small vessel disease.
1.Minimal small vessel disease and otherwise negative CT of brain with infusion.2.Excessive cluster of calcification within the soft tissues of the neck on the left adjacent to the vertebral column with no associated soft tissue mass or bony destruction or abnormal enhancement. The findings may represent posttreatment changes. Further follow-up with an MRI is recommended3.No evidence of residual parotid gland on either side.4.No evidence of a soft tissue mass or pathologic adenopathy.5.Extensive opacification of left mastoid air cells.1.