Left cervical lymph node biopsy showed metastatic adenocarcinoma, most probably from a salivary gland primary. There is a heterogeneous, lobulated mass involving the deep left parotid lobe, which measures up to approximately 2 cm in diameter. The tumor contains small foci of T1 and T2 hypointensity, which may reflect calcifications. There is no gross infiltration of tumor into the parapharyngeal fat or masticator space. The retromandibular vein is mildly compressed by the mass, which also abuts the posterior cortex of the mandibular ramus without erosion. There is a mildly enlarged left level 2B lymph node, which measures up to 15 mm. There is also a left level 4 enlarged lymph node, which measures up to 18 mm. There is no right cervical lymphadenopathy. The other major salivary glands are unremarkable. The thyroid gland is unremarkable. The osseous structures are unremarkable. The airways are patent. There is mild ethmoid and left maxillary sinus mucosal thickening. The imaged intracranial structures are unremarkable.
Deep left parotid mass most probably represents the known adenocarcinoma Ipsilateral cervical and supraclavicular lymphadenopathy was not particularly hypermetabolic on PET and may nevertheless represent metastatic disease versus reactive lymph nodes.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.