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Case Records of the Massachusetts General Hospital
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Volume 361:511-518 July 30, 2009 Number 5
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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 rheumatology clinic of this hospital because of painful swelling on both sides of the neck.

She had been well until approximately 3 months earlier, when dry mouth and increased thirst developed. Two weeks later, submental swelling occurred that was associated with local tenderness, pain on swallowing (with solids more than with liquids), and decreased appetite. Approximately 4 weeks after the onset of symptoms, she saw a physician; cephalexin was prescribed, with no improvement. During the next 2 weeks, pain developed in both ears. 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.



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