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Pathology Quiz Case 2

Pathology Quiz Case 2 A 15-year-old boy presented with a mass in the left side of his neck that had been discovered incidentally several weeks earlier. The mass was not painful and had manifested no inflammatory features. The patient was in good health otherwise and had no additional constitutional symptoms. Physical examination revealed a subcutaneous, nontender, mobile mass measuring 2.0 × 1.5 cm at the posterior border of the left sternocleidomastoid muscle. The overlying skin was intact and normal in color and consistency. No additional cervical masses were palpated. The findings of the remainder of the otolaryngologic and systemic examinations were normal. A complete blood cell count and the results of radiography of the chest were normal. Contrast-enhanced magnetic resonance imaging of the neck demonstrated a homogeneous soft tissue mass in the region of the spinal accessory chain at the junction of levels III and V (Figure 1). There was no necrosis or abnormal enhancement. The findings were otherwise unremarkable. A fine-needle aspirate was “atypical” and demonstrated a mixed population of lymphocytes that included larger lymphoid forms as well as histiocytes and tingible body macrophages. Corresponding flow cytometry studies revealed a monotypic κ-positive population of lymphocytes (15%) in a polyclonal background. An excisional biopsy was performed, and the histopathologic findings are shown in Figure 2 and Figure 3. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload What is your diagnosis? http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology–Head & Neck Surgery American Medical Association

Pathology Quiz Case 2

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Pathology Quiz Case 2

Abstract

A 15-year-old boy presented with a mass in the left side of his neck that had been discovered incidentally several weeks earlier. The mass was not painful and had manifested no inflammatory features. The patient was in good health otherwise and had no additional constitutional symptoms. Physical examination revealed a subcutaneous, nontender, mobile mass measuring 2.0 × 1.5 cm at the posterior border of the left sternocleidomastoid muscle. The overlying skin was intact and normal in...
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Publisher
American Medical Association
Copyright
Copyright © 2007 American Medical Association. All Rights Reserved.
ISSN
0886-4470
DOI
10.1001/archotol.133.10.1063
pmid
17938336
Publisher site
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Abstract

A 15-year-old boy presented with a mass in the left side of his neck that had been discovered incidentally several weeks earlier. The mass was not painful and had manifested no inflammatory features. The patient was in good health otherwise and had no additional constitutional symptoms. Physical examination revealed a subcutaneous, nontender, mobile mass measuring 2.0 × 1.5 cm at the posterior border of the left sternocleidomastoid muscle. The overlying skin was intact and normal in color and consistency. No additional cervical masses were palpated. The findings of the remainder of the otolaryngologic and systemic examinations were normal. A complete blood cell count and the results of radiography of the chest were normal. Contrast-enhanced magnetic resonance imaging of the neck demonstrated a homogeneous soft tissue mass in the region of the spinal accessory chain at the junction of levels III and V (Figure 1). There was no necrosis or abnormal enhancement. The findings were otherwise unremarkable. A fine-needle aspirate was “atypical” and demonstrated a mixed population of lymphocytes that included larger lymphoid forms as well as histiocytes and tingible body macrophages. Corresponding flow cytometry studies revealed a monotypic κ-positive population of lymphocytes (15%) in a polyclonal background. An excisional biopsy was performed, and the histopathologic findings are shown in Figure 2 and Figure 3. Figure 1. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload What is your diagnosis?

Journal

Archives of Otolaryngology–Head & Neck Surgery – American Medical Association

Published: Oct 1, 2007

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