A well -defined, oval-shape cystic lesion measuring 2.6 x 2.0 x 2.0 cm is seen in the left submandibular space (posterior to the submandibular gland, anterior to the sternocleidomastoid muscle and lateral to the carotid sheath). It has mild peripheral enhancement on the post contrast study. Multiple prominent lymph nodes measuring up to 9 mm in short axis are seen at multiple levels on both sides of the neck.