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Clinical Problem Solving: Radiology
February 2005

Radiology Quiz Case 1—Diagnosis

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Copyright 2005 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2005

Arch Otolaryngol Head Neck Surg. 2005;131(2):182-183. doi:10.1001/archotol.131.2.182

The differential diagnosis of the cystic lesion as seen on the T2-weighted gradient echo image included a simple salivary cyst, branchial cleft cyst, lymphoepithelial cyst, and parotid abscess. T2-weighted images often demonstrate differences in intensity on the outer borders of abscesses and branchial cleft cysts, suggestive of tissue thickening. Lymphoepithelial cysts are often associated with human immunodeficiency virus infection. The homogeneous character of the cystic lesion in the present case suggested a simple salivary cyst. Other noncystic lesions that present as hyperintense lesions on T2-weighted images were not considered because the lesion in this case was thought to be a cyst after clear fluid was aspirated from it.

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