A multi-lobulated mass or cluster of smaller masses lies just postero-inferior to the right parotid gland, wrapping around the anterior aspect of sternocleidomastoid and deviating the parotid gland anterolaterally.
This lobulated lesion does involve the tail of the right parotid gland. The mass shows high T2 signal, enhancement and diffusion restriction.
The surrounding subcutaneous soft tissue show mild T2 hyperintensity and mild enhancement.
Linear enhancement is seen within the posterior aspect of the right parotid gland of uncertain nature-it is possible that this represents a segment of the right facial nerve.
No definite abnormal enhancement of the facial nerve within the petrous temporal bone.
Mildly enlarged submandibular nodes are evident bilaterally and there is mild prominence of the left jugulodigastric node.
- Enhancing, multi-lobulated mass arising largely posteroinferior to the right parotid gland but involving the parotid tail consistent with multiple enlarged lymph nodes.
- Mildly enlarged submandibular and left jugulodigastric node.
- Neoplastic aetiology is favoured. Differential diagnosis includes nodal metastases and lymphoma.