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Clinical Problem Solving: Pathology
April 18, 2011

Pathology Quiz Case 2

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Copyright 2011 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2011

Arch Otolaryngol Head Neck Surg. 2011;137(4):411. doi:10.1001/archoto.2011.49-a

A 25-year-old woman presented with 3- to 4-week history of a unilateral, nontender, rapidly enlarging mass in the right side of her neck. Her medical history was remarkable only for radiation exposure near Chernobyl when she was 6 years old. Physical examination revealed a firm, mobile, 1.5-cm mass that was contiguous with the right submandibular gland. There were no cranial nerve defects. A computed tomographic scan identified a right submandibular gland mass (Figure 1). The findings of fine-needle aspiration biopsy were nondiagnostic, however, demonstrating only normal salivary gland tissue. Surgical excision revealed a large, firm gland and inflammation along the anterior border of the sternocleidomastoid muscle and submandibular floor, along with submandibular lymphadenopathy.

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