A huge bizarre-shaped air-fluid collection (mainly air-density) at the left anterior cervical space with involvement of multiple different adjacent neck spaces (transpatial), namely left pharyngeal mucosal and left visceral spaces medially, left masticator space, left parotid space and left buccal space laterally and left pharyngeal space superiorly. Due to the large mass effect of this collection, significant displacement of adjacent medial structures, resulting in a marked displacement of the hypopharynx, larynx, trachea, and thyroid gland to the right side. The tracheal lumen is still patent (25% stenosis).
These collections do not show significant rim enhancement or well-defined wall margin. No retropharyngeal or danger space extension.
Posteriorly, the collection encompasses the adjacent left internal jugular vein within the left carotid space. A few air pockets were seen intra-luminally within the proximal and distal part of the left IJV, representing left IJV thrombophlebitis.
Laterally, the normal left sternocleidomastoid muscle (SCM) is not seen, in keeping with infiltration of the left SCM by the collection. Medially, normal left strap muscles are also involved.
No extension of the collection into anterior and superior mediastinum. Multiple enlarged nodes in the left-sided cervical regions.