A 30-Year-Old with a Painful Neck ‘Bump’ and Difficulty Swallowing

Differential Diagnosis

• Infection (viral upper respiratory, cytomegalovirus, Epstein-Barr, staphylococcal, streptococcal, toxoplasmosis, Bartonella, tuberculosis, HIV)
• Acute sialadenitis
• Right neck mass
• Parotid lymphadenopathy

Diagnosis

The x-rays reveal a large, rounded extrinsic compression of the right-side airway on AP view and prevertebral soft tissue thickening on the lateral view. These findings are consistent with a diagnosis of right neck mass.

Learnings/What to Look for

• Anatomic considerations: This is an anterior process, so likely in anterior aspect of neck.

Pearls for Urgent Care Management

• Further imaging evaluation with ultrasound/CT is warranted immediately.

Acknowledgment: Images and case presented by Experity Teleradiology (www.experityhealth.com/teleradiology).

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