case_images: PMC5664271_01
case_images: Axial CT angiogram showing bilateral cervical lymphadenopathy, the largest of which measures 4 x 3.4 x 2.5 cm (arrow). The posterior portion of the node demonstrates arterial phase enhancement while the anterior portion does not demonstrate it. This mixed density mass has the appearance of a necrotic or haemorrhagic lymph node.
case_images: CRIRA2017-3097414.001.jpg
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case_images: fig1
case_images: It did not demonstrate any vascular injury but revealed significant bilateral cervical lymphadenopathy, largest on the left side, level II measuring 4 x 3.4 x 2.5 cm, with mixed density suggestive of either a necrotic lymph node or, given the history of trauma and rapid swelling, haemorrhage into the lymph node (Figure 1).
case_images: Sagittal CT angiogram demonstrating extensive hypervascularity of lymph nodes in the left neck.
case_images: CRIRA2017-3097414.002.jpg
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case_images: fig2
case_images: Of note, the lymphadenopathy showed signs of hypervascularity which was more in keeping with an infectious aetiology (Figures 2 and 3).
case_images: Coronal CT angiogram of the neck demonstrating extensive hypervascularity of cervical lymph nodes bilaterally which are more pronounced on the left side.
case_images: CRIRA2017-3097414.003.jpg
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case_images: fig3
case_images: Of note, the lymphadenopathy showed signs of hypervascularity which was more in keeping with an infectious aetiology (Figures 2 and 3).
case_images: Ultrasound scan showing an enlarged left cervical lymph node with heterogeneous echogenicity.
case_images: CRIRA2017-3097414.004.jpg
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case_images: fig4
case_images: An ultrasound scan was performed to further characterise the lymphadenopathy, which demonstrated heterogeneous internal echoes with absent colour Doppler flow in the anterior aspect of the lesion (Figures 4 and 5).
case_images: Ultrasound scan of the lesion in question showing colour Doppler flow in the posterior aspect of the lesion only.
case_images: CRIRA2017-3097414.005.jpg
case_images: PMC5664271_01_CRIRA2017-3097414.005.jpg
case_images: fig5
case_images: An ultrasound scan was performed to further characterise the lymphadenopathy, which demonstrated heterogeneous internal echoes with absent colour Doppler flow in the anterior aspect of the lesion (Figures 4 and 5).
case_images: Ultrasound scan showing increased colour Doppler flow through enlarged left cervical lymph nodes.
case_images: CRIRA2017-3097414.006.jpg
case_images: PMC5664271_01_CRIRA2017-3097414.006.jpg
case_images: fig6
case_images: Ultrasonography also demonstrated generalised hypervascular cervical lymphadenopathy, again reflective of an infectious aetiology (Figure 6).