Case 24-2009 -- A 26-Year-Old Woman with Painful Swelling of the Neck

doi:10.1056/NEJMcpc0902221

Volume 361:511-518		July 30, 2009		Number 5

Case 24-2009 — A 26-Year-Old Woman with Painful Swelling of the Neck

John H. Stone, M.D., M.P.H., Paul A. Caruso, M.D., and Vikram Deshpande, M.D.

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Presentation of Case

Dr. John H. Stone: A 26-year-old woman was seen in the rheumatologyclinic of this hospital because of painful swelling on bothsides of the neck.

She had been well until approximately 3 months earlier, whendry mouth and increased thirst developed. Two weeks later, submentalswelling occurred that was associated with local tenderness,pain on swallowing (with solids more than with liquids), anddecreased appetite. Approximately 4 weeks after the onset ofsymptoms, she saw a physician; cephalexin was prescribed, withno improvement. During the next 2 weeks, pain developed in bothears. Seven weeks before evaluation at this . . . [Full Text of this Article]

Differential Diagnosis

Infectious Diseases

Neoplastic Diseases

Immunologic Diseases

Systemic Lupus Erythematosus

Sjögren's Syndrome

Chronic Sclerosing Sialadenitis

Approach to the Diagnosis

Clinical Diagnosis

Pathological Discussion

Anatomical Diagnosis

Source Information

From the Division of Rheumatology, Allergy, and Immunology, Departments of Medicine (J.H.S.), Radiology (P.A.C.), and Pathology (V.D.), Massachusetts General Hospital; and the Departments of Medicine (J.H.S.), Radiology (P.A.C.), and Pathology (V.D.), Harvard Medical School.