Findings:
A small well-defined, ovoid cystic mass in the right paramedian visceral space of the neck, overlaying the body of the hyoid bone on the right side and measuring approximately 7.5 x 6 mm. It has homogenous fluid content and a very thin wall. It displays thin peripheral enhancement on the postcontrast study. No diffusion restriction, only superimposed T2 shine through. No prefixal edema and/or infiltration found. It is located superiorly and superficial to the strap muscles.
Prominent bilateral submandibular lymph nodes are seen, measuring up to 1 cm in short axis.
The tongue and the floor of the mouth have a normal appearance. The retromolar trigone is unremarkable.
The pharyngeal and glottic regions are normal. The parapharyngeal fat space is normal.
The palatine tonsils are symmetrically prominent. The tonsils and adenoids are otherwise unremarkable.
The parotid, submandibular and thyroid glands are normal.
The imaged brain parenchyma is unremarkable. Mild mucosal thickening is seen in the maxillary sinuses bilaterally. The mastoid air cells are clear.
No bony abnormality is seen. The craniocervical junction and spinal canal appear patent.
Conclusion:
Tiny cystic lesion in the right paramedian visceral space of the neck, located superficially to the strap muscles, likely in keeping with a small epidermoid inclusion cyst, DDX thyroglossal duct cyst, which is less likely due to the superficial location of the cyst.