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A 28-year-old woman, originally from the Philippines, presented with a painful, fluctuating swelling of the neck, preceded by peeking fever. CT-imaging showed a multiloculated abscess. A chest X-ray did not show any abnormalities. Incision and drainage were performed. Both PCR and culture revealed an infection with Mycobacterium tuberculosis and the diagnosis of cervical tuberculous lymphadenitis was made.

When resecting head and neck tumours, the aim is mostly to strive for en bloc resection with sufficiently large tumour-free margins. If this is not possible, as is frequently the case with transoral laser microsurgery and endonasal endoscopic surgery, multiblock resection can be carried out by cutting through the tumour. With this approach, it is also essential that the final resection margins are tumour-negative. In such cases, surgeon and pathologist together should pay extra attention to tissue orientation and outer resection margins.

The TNM-classification of the UICC is used for staging malignant tumours worldwide. From 2003 the new revised sixth edition must be used. In comparison with the fifth edition there are some general and some head and neck carcinoma specific alterations. Some designations are introduced if sentinel lymph node procedure or immunohistochemistry or molecular methods have been used. In the revised version some definitions for advanced tumour stages at several head and neck sites are changed. In the new classification of the primary tumour the terms erosion and invasion of cartilage or bone are used. At most head and neck sites T4 is divided in T4a and T4b.

Positron emission tomography (PET) is a relative new diagnostic imaging technique. In patients tumour tissue can be visualized using PET camera after intravenous injection of fluor-18-deoxy-glucose (FDG). In patients with head and neck squamous cell carcinoma FDG-PET seems to be especially suitable to find an occult primary tumour in patients with a cervical lymph node metastasis of an unknown primary tumour, to screen for distant metastases and second primary tumours and to detect a recurrent laryngeal carcinoma after radiotherapy. For these indications FDG-PET may play a role in the prevention of unnecessarily diagnostic examinations and treatments. The definitive value of FDG-PET for these indications is currently under further investigation. The role of FDG-PET for the detection of lymph node metastases and prediction and monitoring of response on radiotherapy and chemotherapy is yet unclear. Developments of new techniques like fusion of PET with CT and MRI, the use of positron emitter labelled monoclonal antibodies and new tracers are in progress.