Findings: An enlarged right upper cervical lymph node ( level II) showing significant peripheral enhancement and central necrosis, measuring 2.5 x 3.2 cm. Another necrotic lymph node measuring 12 x 13 mm is seen in the superior mediastinum, left paratracheal in location. No additional enlarged cervical lymph nodes. Average size heterogeneous thyroid gland with multiple thyroid nodules in both lobes. A few small nodular soft tissue densities are appreciable in both parotid glands which are likely small intraparotid lymph nodes. A note is made of mildly tortuous and medialized right common and internal carotid arteries (retropharyngeal carotid artery).
Impression: Enlarged heterogeneous right upper cervical and superior mediastinal lymph nodes which are likely metastatic in nature. Bilateral thyroid nodules. For further evaluation with thyroid ultrasound and FNAC.