Odynophagia, weight loss. History of neutropenia; evaluate for sinus infection. Sinus CT :Polypoid mucosal thickening is seen in left maxillary sinus. No air fluid level is seen.Neck CT:There is poor contrast opacification which may limit the sensitivity of the study.There are large CSF density lesions in bilateral middle cranial fossa, which may represent arachnoid cysts. There is compression of the adjacent brain parenchyma in the temporal lobes. Further correlation with MRI brain should be considered.No obvious mass or adenopathy based on size criteria is seen in the neck. There is subtle asymmetric thickening of the right aryepiglottic fold of uncertain clinical significance. No obvious mass is seen.There is mild thickening of the esophagus, but this can be secondary to lack of distention.Atherosclerotic changes are seen in the carotid arteries.The right submandibular gland is atrophic.There is severe degenerative disease of the cervical spine. There is anterolisthesis of C2 on C3 and C3 on C4. Disk osteophyte complexes and degenerative disease of the uncovertebral joints and facet joints are seen in multiple levels, resulting in spinal canal and neuroforaminal stenosis, with mild impingement of the spinal cord, and nerve roots.
1. Polypoid mucosal thickening in the left maxillary sinus.2. Subtle asymmetric thickening of the right aryepiglottic fold of uncertain clinical significance. No obvious mass is seen. Please also correlate with clinical examination.3. Mild thickening of the esophagus may be related to lack of distention. If patient's symptoms persist, barium swallowing study or endoscopic examination of the esophagus should be considered. 4. Large arachnoid cysts in bilateral middle cranial fossa, causing compression of the brain parenchyma. Further evaluation with MRI brain should be considered.5. Severe degenerative disease of cervical spine, with listhesis at multiple levels. There is spinal canal and neuroforaminal stenosis at multiple levels.