A previously healthy 43-year-old woman presented with a 2-month history of a mass in the right side of her neck. The mass had started as a small lesion that the patient attributed to a possible bug bite. Shortly thereafter, the lesion enlarged and became extremely painful and tender. Also, there was a small amount of spontaneous purulent drainage. During the ensuing 2 months, the mass continued to grow slowly but was no longer causing pain. The patient noted no further drainage and complained only of mild irritation caused by collared shirts. She had received no treatment and had undergone no diagnostic workup before consultation. She denied having fevers, chills, night sweats, weight loss, or other neck masses. Her medical history was otherwise unremarkable, and a review of systems revealed no other abnormalities.
Harsha WJ, Wilson A, Tremaine L, Hanson JR. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2007;133(8):840. doi:10.1001/archotol.133.8.840