R. NICKBRYANMDPATRICIA A.HUDGINSMD
A 14-year-old African American girl presented with a 2-month history of bilateral neck swelling, on the left more than on the right. She complained of mild tenderness, decreased range of motion in her neck, and nasal congestion. She had no fever, nausea, vomiting, dysphagia, or respiratory distress. There were nocranial nerve deficits. She was initially treated with oral antibiotics, with no improvement in her symptoms. Her medical history was otherwise unremarkable. An axial computed tomographic scan demonstrated bilateral lymphadenopathy with areas of central hypodensity consistent with necrosis (Figure 1).
Dean R, Pitman K, Chu J. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2004;130(6):796. doi:10.1001/archotol.130.6.796