sb/hs/nl
/62 Date : 00.00.00

Name of the Patient : Abc XyzShlmn / M / 31 yrs.
Referred by : Dr. Abc Xyz Kasbekar.
Examination : M.R.I. of the Right Parotid Gland.

CLINICAL PROFILE :

C/O swelling in the region of the right parotid gland since 10 years.
FNAC s/o salivary gland neoplasm favouring mixed salivary gland tumor (Pleomorphic Adenoma).

EXAMINATION :

M.R.I of the right parotid gland was performed using the following parameters :

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

4 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a well-defined, approximately 2.1 x 2.8 x 3.1 cms sized intermediate signal intensity mass lesion on the T1 Weighted images in the superficial lobe of the right parotid gland, anteriorly, anterior to the posterior margin of the ramus of the mandible. This lesion appears hyperintense on the T2 Weighted and STIR images. Resultant slight indentation on the postero-lateral margin of the right masseter muscle is noted with effacement of the retro-mandibular vein.

There is seen another, approximately 0.9 x 2.0 x 1.1 cms sized hyperintense lesion on the T2 Weighted and STIR images in the right medial pterygoid muscle. This lesion is isointense to normal muscle on the T1 Weighted images and is separate from the deep lobe of the right parotid gland. This lesion is also outside the right parapharyngeal space.




Small, subcentimeter lymph nodes are noted deep to the sternocleidomastoid muscles on either side.

Inflammatory changes are noted in the maxillary sinuses and ethmoidal air cells bilaterally.

The submandibular glands, left parotid gland and the visualized lobes of the thyroid gland are unremarkable. The parapharyngeal spaces and the prevertebral space also appear normal. The visualized carotid sheaths also appear unremarkable. No obvious bone erosion or destruction is seen.


IMPRESSION :

1. An approximately 2.1 x 2.8 x 3.1 cms sized mass lesion in the superficial lobe of the right parotid gland, anteriorly, anterior to the posterior margin of the ramus of the mandible as described represents a parotid gland tumor (HP s/o Pleomorphic adenoma).

2. Another, approximately 0.9 x 2.0 x 1.1 cms sized mass lesion in the right medial pterygoid muscle which is separate from the deep lobe of the right parotid gland is not specific for a single etiology. This most likely represents a hematoma/inflammatory lesion due to previous biopsy. The possibility of another salivary gland tumor arising from cell-rests seems less likely.

3. Inflammatory changes in the maxillary sinuses and ethmoidal air cells bilaterally.