A 49-year-old man with a 60 pack-year smoking history presented with a 1-month history of progressively worsening pain in the posterior aspect of the right side of his neck. He denied recent neck trauma, fevers, chills, weight loss, dyspnea, chest pain, dysphagia, odynophagia, and otalgia and had no history of head and neck surgery or radiation therapy. His medical history was remarkable for approximately 6 months of intermittent coughing of blood-tinged sputum. He reported no recent travel. He considered himself otherwise healthy and had not seen a primary care provider in more than 25 years.
Brown JE, Blumin JH. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2012;138(6):605. doi:10.1001/archoto.2012.504a