ESR Essentials: pseudolesions in head and neck-practice recommendations by the European Society of Head and Neck Radiology.

The differentiation between pathological and physiological entities constitutes a fundamental aspect of daily radiological practice. Pseudolesions manifest as a transient phenomenon within this spectrum, displaying features of pathology within the context of normal or variant anatomy. A variety of structures, including vascular components, ectopic formations, or deviations from typical developmental patterns, can mimic pathological entities. It is crucial to discern between the two: lesions warranting treatment or ongoing radiological monitoring and pseudolesions where further analysis or treatment is unnecessary. Radiology plays a key role in classifying these entities. Comprehensive knowledge and accurate assessment of head and neck pseudolesions are necessary for radiologists to avoid unnecessary further diagnostic tests, treatments, and distress for the patient. KEY POINTS: Pseudolesions are an aspect of typical anatomy. Ectopic structures will have the same intensity/density no matter the location. Pursuit of a vascular origin can be a problem solver. Incorporate pseudolesions in the report.