R. NICKBRYANMDPATRICIA A.HUDGINSMD
A 52-year-old man presented with a sudden onset of swelling and pain in the left side of his neck, accompanied by dyspnea and stridor. He denied any previous trauma, particularly of the neck and head. His medical and family histories were unremarkable.
On physical examination, the patient looked ill but was afebrile. A nontender, diffuse, tense bulging without local heat was noted on the left side of his neck. Laryngoscopy, which was performed before tracheostomy, revealed a protrusion of the lateral wall on the left side of the pharynx. The results of a complete blood cell count, blood chemistry profile, measurement of C-reactive protein, and serologic tests for syphilis were normal. A neck x-ray film was obtained (Figure 1). Contrast-enhanced computed tomography (CT) of the neck (Figure 2) and angiography of the left carotid artery (Figure 3) were also performed.
Chen S, Young C, Cheng P. Radiology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2005;131(9):822. doi:10.1001/archotol.131.9.822