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Clinical Problem Solving: Radiology
May 18, 2009

Radiology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2009;135(5):516-519. doi:10.1001/archoto.2009.34-a

A 45-year-old woman presented with a 3-week history of low-grade fever and increasing dysphagia to solids and a 1-week history of a progressive swelling in the right side of her neck. Physical examination revealed that she had a temperature of 38° C and a 4 × 2-cm, tender, firm swelling in right lower cervical region. A few discrete, tender, firm but mobile lymph nodes were palpable along the midjugular chain. The findings of indirect laryngoscopy as well as examination with flexible laryngoscope were normal. Hematologic investigations showed mild anemia and a slightly elevated total leukocyte count, with 73% neutrophils. The erythrocyte sedimentation rate was 85 mm/h. Chest radiography revealed no abnormalities.