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Clinical Problem Solving: Radiology
February 1, 2008

Radiology Quiz Case 2

Author Affiliations

Patricia A.HudginsMD

Arch Otolaryngol Head Neck Surg. 2008;134(2):211. doi:10.1001/archoto.2007.32-a

A 64-year-old white man presented with a 3-week history of a painless progressive neck swelling in the left side of his neck and a 2- to 3-month history of an intermittent sore throat and a chronic, dry, tickly cough. He had no history of recent upper respiratory tract infection, dysphagia, odynophagia, weight loss, otalgia, or hoarseness. He denied any epistaxis, night sweats, or breathing difficulties.

Physical examination revealed a left-sided diffuse, firm to hard, nontender neck swelling, measuring 4×3 cm in diameter, deep to the upper one-third of the sternocleidomastoid muscle. The swelling was fixed, with no signs of local inflammation. There were no palpable neck nodes. Examination of the oral cavity, oropharynx, nasopharynx, and laryngopharynx showed no abnormalities. There was no generalized lymphadenopathy, and the findings of the general physical and systemic examinations were normal.

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