History: neck swelling
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Case 33 Answer
Answer: bilateral Internal jugular venous thrombosis (quite extensive I might say!)
Given the extensive nature (and the somewhat shaggy appearance above), I think bringing up the thought of Lemierre Syndrome is wise. Remember that Lemierre syndrome is septic thrombosis of the internal jugular veins (usually due to throat/neck infection) with distal septic thrombotic emboli.
short reference: http://radiopaedia.org/articles/lemierre-syndrome
Nice Radiology article: http://pubs.rsna.org/doi/pdf/10.1148/radiology.213.2.r99nv09369