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Past Issue:
Volume 20, Number 4 • October 2007
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Bilateral neck swelling in a 40-year-old woman with HIV

Brandon Chau, MD, Manu Gupta, MD, and William G. Schucany, MD

A 40-year-old African-born woman with HIV presented with a several-month history of progressive, painful bilateral neck swelling. She stated that she had been unable to eat because of the excruciating pain. She reported intermittent fevers as well but denied any shortness of breath or cough. She also reported right upper-quadrant abdominal pain and mild abdominal distension. She was admitted to the hospital, and her workup included contrast-enhanced computed tomography (CT) of the neck, chest, abdomen, and pelvis (Figures 1-5).

What are the differential diagnostic considerations? What is the most likely diagnosis? What tests can confirm the diagnosis?