頸靜脈腫脹？

病患者男 - 34歲

醫生, 你好~ 病人做左頸既超聲波同電腦掃瞄
報告如下 , 先多謝醫生既回覆感激!

1. 請問以下報告係咪指病人有頸部靜脈腫脹？
2. 會唔會有生命危險？
3. 會唔會變癌症？
4. 我哋應該點治療？
5. 如果唔治療會點？
6. 我哋應要定期去照電腦掃描觀察住嗎？
7. 如要睇專科應該睇邊一科?
8. 就以下報告反映病人可以打復必泰嗎？
9. 點解病人同時會有頸部靜脈腫脹 / 水瘤囊腫0.21cm / 1.05cm發炎性頸淋巴

好多謝醫生既回覆!!!!

EXAM. DATE: 07/08/2021
Computed Tomography Report
CT Neck with & without contrast

TECHNIQUE
Serial axial scans were performed from the base of the skull to the lung apices with and without intravenous contrast injection using a 256 slice MDCT.

CLINICAL HISTORY
Left neck swelling during straining and in prone position.

FINDINGS
Nasopharynx has a smooth outline. No focal mass lesion is noted. No abnormal obliteration of the para-pharyngeal fossa of both sides can be seen.

The epiglottis appears unremarkable. No abnormal thickening is noted. No abnormal obliteration of the pyriform sinus on either side can be seen. No abvious mass lesion around the vocal cord is noted.

The hypopharynx and the upper oesophagus has normal configuration. No abnormal wall thickening or mass lesion is noted.

The submandibular and parotid glands on both sides appear normal in configuration. No focal mass lesion is noted. No abnormal density to suggest stone formation is noted.

Prominent lymph nodes are seen in bilateral upper cervical region. The large one in the left side measures 1.05cm. These can be reactive in nature. No abnormally enlarged lymph nodes in bilateral cervical regions are seen.

A marker is places in the left side neck, corresponds to the site of palpable mass clinically. Underneath the marker, no abnormal mass or fluid collection is seen.

No focal bony destruction can be seen.

COMMENTS
- A marker is placed in the left side neck, corresponds to the site of palpable mass clinically. Underneath the marker, no abnormal mass or fluid collection is seen. Target ultrasound is also done. Under ultrasound and at prone position, the clinically palpable mass probably corresponds to a distended vein in the superficial tissue of the neck, which is probably the left anterior jugular vein. No other mass in the anterior aspect of the neck is seen. Follow-up imaging will be helpful if clinically indicated.
-Prominent lymph nodes are seen in bilateral upper cervical region. These can be reactive in nature.
- No abnormal mass or fluid collection in the neck can be seen.

Date Request: 16/07/2021
RADIOLOGY REPORT
ULTRASONOGRAPHY OF NECK

FINDINGS
The isthmus and both lobes of the thyroid gland are normal in size, outline and echotexture.
The right and left lobes of the thyroid gland measure 1.92 x 1.44 x 4.97cm (TS x AP x CC) and 2.11 x 1.26 x 4.61cm (TS x AP x CC) respectively.
There is no retrosternal extension of the thyroid gland.
A 0.21cm colloid cyst is noted at left thyroid lobe lower pole.

Both parotid and submandibular glands are normal in size, outline and homogenous in parenchymal echogenicity. No focal submandibular or parotid mass is seen.

There is no enlarged or abnormal-looking cervical lymph node in bilateral neck.

COMMENTS
- Colloid cyst at left thyroid lobe lower pole.
- No other focal lesion is detected.

高國進醫生回覆: [ 12/24/2021 ]

78849你好

電腦掃描顯示的主要有兩個描述，但並不是什麼嚴重的問題。
報告提出的可能性是局部前端左頸靜脈擴張，可能是先天發育有些微差異，亦有可能是這部份頸靜脈瓣不能完全閉合，靜脈血液長久倒流引致靜脈擴張。

靜脈血管壁並沒有加厚。並沒有任何腫瘤，水囊也沒有。如果令人有甚麼特別的病徵，保守起見，報告建議之後再照一次，來看看有冇新進展／惡化，作進一步確認。

根據報告所描述，這不會有任何生命危險。
如果沒有影響日常生活，如呼吸困難、聲音沙啞、影響觀瞻，或沒有逐漸增大，可以不用做手術。亦不需要任何治療。

報告說明只需要再照一次，沒有必要定期去照，因為報告並沒有提及癌腫瘤的可能性。

如果要看專科，建議看頭頸外科，或整容外科。
病人可以打復必泰疫苗。

水囊是良性的，跟面部生痣一樣普遍。
1cm大發炎性淋巴，有很多原因，可以是蛀牙、傷風感冒、皮膚炎，並不一定是大問題。

以上資料只供參考，不能作診症用途，
請與家庭醫生查詢並作出適合治療。
如有身體不適請即求診，切勿延誤治療。
若資料有所漏誤，本網及相關資料提供者恕不負責。