Pathologie Quiz Case 1
A 14-month-old black girl was referred for evaluation of a slowly enlarging left submandibular mass that had been present for 3 weeks. A tuberculin skin test was nonreactive, and the mass enlarged despite 10 days of amoxicillin–clavulanate therapy. The patient was otherwise healthy, without fever, cough, or other systemic complaints.
Her head and neck examination was remarkable only for a 3X3-cm mass in the left submandibular triangle, which was firm but not fixed. The mass was neither warm nor tender, and no changes were present in the overlying skin. No other significant adenopathy was found on head and neck and general physical examinations.
Computed tomography with intravenous contrast showed a submandibular mass with low attenuation centrally and some rim enhancement (Figure 1 [arrow indicates the mass]). Fine-needle aspiration was performed, revealing a polymorphous population of mononuclear cells and occasional large reactive histiocytes containing intact lymphocytes (Figure 2).
Woods RH, Tunkel DE, Sherman ME, et al. RESIDENTS PAGE: PATHOLOGY. Arch Otolaryngol Head Neck Surg. 1993;119(12):1378–1382. doi:10.1001/archotol.1993.01880240118017
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