Female, 73 years old, with right hard palate lesion. An enhancing mass is evident centered within the maxillary alveolus at the location of the right lateral incisor. This lesion measures 12 x 11 mm in the sagittal plane and 11 x 11 mm in the coronal plane. The lesion involves the alveolus and the underlying hard palate mucosa. There is a mild invasion into the overlying hard palate, but no invasion through the hard palate or involvement of the nasal cavity is seen.As noted on the prior CT, there is also evidence of erosion along the posterior right maxillary alveolus (see image 23 series 13). The erosive defect is filled with nonspecific soft tissue which demonstrates ill-defined enhancement and mildly hyperintense T2 signal.A cluster of small lymph nodes is evident just lateral to the submandibular glands bilaterally, but more so on the right. Although individually these lymph nodes do not meet imaging criteria for pathologic enlargement, they are somewhat concerning due to their increased number. Lymph nodes are also evident bilaterally at level 2, but again none of these meets imaging criteria for pathologic enlargement.The salivary glands and thyroid are unremarkable. No additional soft tissue neck lesions are seen. Bone marrow characteristics are unremarkable. Limited intracranial views demonstrate patchy asymmetric periventricular T2 hyperintensity which may reflect microvascular ischemic disease. The paranasal sinuses and nasal cavity are otherwise unremarkable allowing for a small mucous retention cyst in the right maxillary sinus.
1.An erosive lesion is evident along the right maxillary alveolus at the level of the lateral incisor. This lesion involves the alveolus and underlying mucosa with minimal encroachment upon the hard palate. No evidence of extension through the hard palate into nasal cavity is seen.2.A second area of bone erosion is seen more posteriorly along the right maxillary alveolar ridge. This region demonstrates mildly elevated T2 signal and mild ill-defined enhancement. Findings are nonspecific and may very well reflect a benign etiology, but direct inspection of this region is highly recommended.3.No definite pathologic adenopathy is detected in the neck by size criteria. Lymph node clustering along the submandibular glands, right side more than left, is somewhat concerning due to the unusual increased number of these nodes. Additional lymph nodes at level 2 bilaterally are nonspecific as they do not meet imaging criteria for pathologic enlargement.