DESCRIPTION:
1) Extending from the fossa of Rosenmueller in the right nasopharyngeal space is an irregular mass which measures approximately 2.6 x 1.7 cm and demonstrates avid FDG uptake with an SUV of 12.3. There is an enlarged level II lymph node
on the left just adjacent to the oropharynx which demonstrates FDG uptake with an SUV of 8.0. Additionally, several small level V lymph nodes also seen on the left which demonstrate mild FDG uptake with SUV of 2.5.

2) Surgical changes are seen on the right in the region of the angle of the mandible adjacent to the right sternocleidomastoid muscle to include soft tissue emphysema, inflammatory fat stranding, and mild FDG uptake in this region. Focal region of FDG uptake with an SUV of 5.0 likely represents lymph node which may represent metastatic focus or may be reactive in nature. No other enlarged or FDG avid lymph nodes are seen.

Diagnosis: Nasopharyngeal carcinoma with left sided metastatic lymph node.