Presentation
Right lower neck swelling - few days. Referred for ultrasound.
Patient Data
Multiple nodes are noted in right level IV .Nodes are rounded, hypoechoic with loss of hilar fat. Central and capsular vasculariy is noted in all nodes. Morphologically similar nodes are noted in right level V and Left level IV. Rest of the neck examination was normal.
IMPRESSION :Bilateral level IV and RIght level V nodes - possibility of malignent neoplatic nodes likely.
Abdomen Ultrasound : Para-aortic, retrocaval, aorto-caval discrete hypoechoic nodes are noted.
Scrotal Ultrasound : No testicular mass or other abnormality is noted.
Case Discussion
CT was next investigation with FNA. No abdominal mass noted.
FNA - Metastatic nodes.
Tumor markers : CEA – High.
CA – 19-9 – Normal.
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