Endgames Spot Diagnosis

A persistent cough

BMJ 2016; 354 doi: https://doi.org/10.1136/bmj.i4858 (Published 28 September 2016) Cite this as: BMJ 2016;354:i4858
  1. H L Adams, specialty registrar, radiology1,
  2. D C Howlett, consultant radiologist2
  1. 1Brighton and Sussex University Hospitals, Brighton, UK
  2. 2Department of Radiology, East Sussex Healthcare NHS Trust, Eastbourne, UK
  1. Correspondence to: H L Adams h.l.adams{at}doctors.org.uk

A 60 year old woman presented with a hoarse voice and persistent dry cough. Flexible nasendoscopy showed a smooth, round swelling on the posterior third of the tongue.

What abnormality is shown in the midline at the posterior tongue base on this axial T2 weighted magnetic resonance image (fig 1)?

Fig 1 Axial section, T2 weighted magnetic resonance image at the level of the tongue base.

Answer

A cystic remnant of the thyroglossal duct (thyroglossal cyst).

Discussion

The magnetic resonance image shows a thin walled, cystic lesion in the …

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