title: The "small, dark tonsil" in patients presenting with metastatic cervical lymphadenopathy from an unknown primary.
abstract: When squamous cell carcinoma (SCC) involves the palatine tonsils, they are generally enlarged and demonstrate intermediate to high signal intensity on T2-weighted MR images and enhance after gadolinium administration. We have identified two patients with SCC of the tonsil where the affected tonsil has low signal intensity on T2-weighted MR images and is smaller than the contralateral normal tonsil. We present the "small, dark tonsil" as an alternative imaging presentation of SCC and a new sign to look for when evaluating the patient with metastatic lymphadenopathy from an unknown primary tumor.
authors.affiliation: Department of Neuroradiology, University of California-San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
authors.forename: Jacque R
authors.initials: JR
authors.lastname: Jumper
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Fischbein
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Kaplan
authors.forename: Harvey Z
authors.initials: HZ
authors.lastname: Klein
authors.forename: William P
authors.initials: WP
authors.lastname: Dillon
mesh_terms: D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000556:secondary*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D009382:Neoplasms, Unknown Primary; D014067:Tonsillar Neoplasms / Q000473:pathology* / Q000556:secondary*