SECTION EDITOR: EDWARD B. STELOW, MD
A 70-year-old man presented with a recurrent right parotid mass. Five months earlier, he had presented at an outside hospital with a 4.3 × 3.2 × 2.6-cm level 2 mass in the right side of his neck. Two months after the excision, the mass recurred. Magnetic resonance imaging of the neck showed a 6 × 5-cm ill-defined mass of low signal intensity in superficial and deep parotid lobes, with infiltration of the surrounding soft tissues (Figure 1). A chest radiograph revealed multifocal opacities. Positron emission tomography–computed tomography showed diffuse hypermetabolic lymphadenopathy throughout the body and hypermetabolic activity in the right parotid gland. An excisional biopsy specimen of a level 2 lymph node on the right side demonstrated follicular hyperplasia, increased immunoblasts, germinal centers, and mantle zones, with no evidence of lymphoma.
Yuan JT, Said J, Blackwell KE. Pathology Quiz Case 1. JAMA Otolaryngol Head Neck Surg. 2013;139(2):193. doi:10.1001/jamaoto.2013.1268a