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Clinical Problem Solving: Radiology
June 2004

Radiology Quiz Case 1

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Copyright 2004 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2004

Arch Otolaryngol Head Neck Surg. 2004;130(6):796. doi:10.1001/archotol.130.6.796

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).

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