 There is a multinodular goiter with enlargement of the bilateral thyroid lobes and isthmus. For example left thyroid lobe measures up to 5.1 cm in the AP dimension and isthmus measures 2.2 cm in the AP dimension. There is inferior extension into the superior mediastinum bilaterally. No significant airway narrowing. No significant mass effect on the brachial plexus is appreciated, which is lateral to the goiter. There is no signal abnormality involving the brachial plexus nerve roots, trunks, or cords. Degenerative changes involving the cervical spine at C5-C6, C6-C7, and C7-T1 are again seen. Slightly prominent submental lymph nodes in the midline are again noted.
1. Significantly enlarged, multinodular thyroid gland with mild extension into the superior mediastinum. 2. No abnormal signal involving the brachial plexus or mass effect on the brachial plexus related to the goiter is seen.3. Degenerative changes involving the lower cervical spine including significant right C5-C6 and C7-T1 neural foraminal stenosis better assessed on dedicated cervical spine MRI study.