2-year-old male with history of neuroblastoma. Status-post two cycles of chemotherapy. Follow up exam. Views of the soft tissue neck show a large relatively homogeneous mass involving the left super mediastinum. This mass extends from the level of the thyroid gland and posterior to the carotid space down through the thoracic inlet. The inferior extent of this lesion is limited due to cut off however it extends beyond the thoracic inlet. This mass currently measures 44.3 x 29.9 mm in the transverse oblique and AP projections, and on the prior MRI exam it measured 38.1 x 23.7 mm on prior MRI exam in one accounting for differences in technique there is suggestion of mild interval increase in the size of this lesion.The remaining views and soft tissue neck show multiple lymph nodes involve the jugular chain and posterior triangle region with a prominent enhancing node involving the left jugular chain jugular digastric region approximating 14.4 mm. there is mild prominence of the tonsillar tissue within the oropharynx with no significant compromise of the pharyngeal/laryngeal airway. Normal enhancement is seen involving the carotid vasculature.
1. The large left-sided superior mediastinal mass with low cervical involvement air as described above. When accounting for differences in technique there is suggestion of mild interval increase in size from the previous MRI performed on 4/7/2010.2. Cervical lymphadenopathy most prominent in the left jugulodigastric region. See above discussion.