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FIG 1. Case 1. A 6-year-old girl with an ill-defined lesion of the left pyriform sinus.
A, Contrast-enhanced axial CT scan shows a moderately enhancing mass (black arrows) in the left pyriform sinus. It extends to the submandibular gland (arrowhead) and platysma muscle (white arrow). The left submandibular gland is enlarged and has multiple small nonenhancing portions. Multiple, small, homogeneous, well-defined oval lymph nodes are found in both internal jugular chains (open arrows).
B, Photomicrograph of a specimen shows actinomycotic granules (thin arrows) and adjacent necrosis (arrowheads). These are surrounded by granulation tissue and fibrosis (thick arrows) (hematoxylin-eosin stain, original magnification x200).
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