The patient (H. J. K.), a white man 57 years old, was admitted to the hospital on July 5, 1949, for treatment of a vesicular eruption of both hands. On examination, in addition to the skin lesions, a mass of discrete cervical nodes was found beneath and anterior to the angle of the right jaw. The patient stated that the swelling was noticed four or five months previously. His attention was called to it by his associates rather than by any localized pain or discomfort. Slight discomfort had been present, but it was thought to be due to a cervical arthritis which had been present for three or four years. There was a feeling of fullness on swallowing, which the patient said he thought was due to his "uvula." A right simple mastoidectomy had been done in 1928, with no residual effects.
In the search for the etiological factor of