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Clinical Problem Solving: Pathology |

Pathology Quiz Case 1

Jeremiah C. Tracy, MD; Ian Mukand-Cerro, MD; Richard O. Wein, MD
Arch Otolaryngol Head Neck Surg. 2012;138(11):1091. doi:10.1001/2013.jamaoto.345a 10.1001/2013.jamaoto.345b.
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A 72-year-old woman presented with a mass in the right side of her neck. The mass, which was located in level III, had initially been noticed 4 months earlier and had been slowly enlarging since then. Physical examination revealed that the mass was superficial, freely mobile, and nontender. The patient's medical history was remarkable for a diagnosis of tuberculosis, which had previously been treated in China. There was no history of neck trauma or surgery.

A computed tomographic scan of the neck with contrast demonstrated a heterogeneous vascular mass (1.8 × 1.7 × 1.2 cm) just superficial to the sternocleidomastoid muscle in the right side of the neck. The mass appeared to involve or compress the external jugular vein. A fine-needle aspirate yielded grossly bloody fluid that was nondiagnostic. Subsequently, the mass was excised.

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