Head and Neck #4 – Flashcard

CT – Coronal + C
CT – Axial + C
Where is the abnormality?​

Left side of the neck.

How can the abnormality be described?​

Multiple enlarged neck clustered lymph nodes, with some of them showing necrosis.

What is the differential diagnosis?

Infectious lymphadenitis: such as TB or pyogenic lymphadenitis.
Metastasis: particularly from head and neck malignancies.
Treated lymphoma or lymphoma in immune compromised patient.

What is the final diagnosis

TB lymphadenitis

Head and Neck – Flashcard #2

What do you see on the following images?

Click here to see the answer

Dehiscent jugular bulb

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.

Head and Neck – Flashcard #1

Axial CT bone window

What do you see on this image?

Click here to see the answer

Otosclerosis

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.