Pharyngitis with Early Suppurative Retropharyngeal Lymphadenitis, CT
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0136-Pharyngitis with Early Suppurative Retropharyngeal Lymphadenitis, CT
View Images
CA0136-Pharyngitis with Early Suppurative Retropharyngeal Lymphadenitis, CT
Case ReportHistory
Exam
Findings
Nasopharynx Including Retropharyngeal Lymph Nodes
The appearance of the nasopharynx is normal for age and there is no edema or developing abscess within the adjacent parapharyngeal space.
Oropharynx
There is thickening of the posterior pharyngeal wall. The palatine and lingual tonsillar tissue, the lymphoid tissue along the glossotonsillar sulci and posterior pharyngeal wall appear normal.
Retropharyngeal Lymph Nodes
There is suppurative retropharyngeal lymphadenopathy on the left. The maximum short axis diameter of this lymph node is 15 mm.
The margins of the suppurative node and extensive edema in the adjacent parapharyngeal and retropharyngeal spaces make exclusion of early nodal rupture difficult. Secondary to the edema, there is bulging of the left pharyngeal wall on the level of the oro/hypopharynx without significant narrowing of the airway.
There is reactive retropharyngeal lymphadenopathy on the right.
Hypopharynx, Larynx, Deep Neck and Entire Retropharyngeal Space
There is thickening of the mucosa of the posterior pharyngeal wall within in the hypopharynx. There is edema/cellulitis in the adjacent retropharyngeal space. More caudally and on the right side, the cellulitis spreads to the retropharyngeal and parapharyngeal spaces and deep neck.
Major Salivary Glands
There is not significant abnormality of the parotid, submandibular or sublingual glands that would be an alternative explanation for the patient’s symptoms.
Other Cervical Lymph Nodes
There is reactive cervical lymphadenopathy in level 2, 3 and 4 on the left, without evidence of suppuration. The lymph nodes on the right are prominent but normal by imaging criteria.
Vascular Findings
There is no evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein or smaller venous tributaries.
Upper Lung Zones and Mediastinum
The upper lung zones and mediastinum visualized are normal.
General Facial, Pharyngeal and Neck
There is mild mucoperiosteal thickening in both maxillary sinuses and in a few ethmoidal air cells. There is opacification of the left mastoid and partial opacification of the left middle ear.
Impression
The airway is patent and there is no vascular thrombosis.
