The "small, dark tonsil" in patients presenting with metastatic cervical lymphadenopathy from an unknown primary.
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.
Jumper
Jacque R
JR
Department of Neuroradiology, University of California-San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143, USA.
Fischbein
Nancy J
NJ
Kaplan
Michael J
MJ
Klein
Harvey Z
HZ
Dillon
William P
WP
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*