Left side of the neck.
Multiple enlarged neck clustered lymph nodes, with some of them showing necrosis.
Infectious lymphadenitis: such as TB or pyogenic lymphadenitis.
Metastasis: particularly from head and neck malignancies.
Treated lymphoma or lymphoma in immune compromised patient.
TB lymphadenitis
Situated at the left common carotid artery bifurcation.
Enhancing soft tissue tumor splaying the internal and external carotid arteries.
Hyperintense on the STIR with dark foci giving salt and pepper appearance. Hypointense on T1.
Carotid body tumor: glomus tumor or paraganglioma of the carotid body. It characteristically splays the internal and external carotid arteries.
Vagal schwannoma: tends to displace both arteries together to one side.
Glomus vagale: paraganglioma with the same signal characteristics as the carotid body paraganglioma but is located more superiorly at the skull base and may extend into the jugular foramen.
Diagnosis: Carotid body tumor.
What do you see on the following images?
The jugular bulb bulges into the left middle ear cavity with absence of the sigmoid plate separating the jugular bulb from the middle ear in keeping with dehiscent jugular bulb.
It is one of the causes of pulsatile tinnitus, patients can also present with conductive hearing loss if the jugular vein contacts the tympanic membrane.
What do you see on this image?
There is a small lucency anterior to the vestibule, just lateral to the basal turn of the cochlea. Consistent with fenestral otosclerosis.
There are two types of otosclerosis:
1- Fenestral: is the most common type. It involves the bone anterior to the oval window and causes conductive hearing loss.
2- Retro-fenestral: involves the cochlear capsule and causes sensorineural hearing loss.
The two types can occur simultaneously.
