Recent immigrant from India.
Gradual swelling and fluctuance in the right supraclavicular fossa.
There is a heterogenous predominantly hypoechoic collection measuring 20 x 17 x 15mm in the right supraclavicular region corresponding to the palpable mass.
A subtle tract can be seen diving more deeply into the upper mediastinum and CT is recommended to further evaluate this region.
The appearance is most consistent with an abscess, and possibly a collar stud type abscess.
This was later found to be a tuberculous abscess.
This heterogenous collection is clearly shown to be liquid using probe pressure that causes the debris within the collection to move.
The differential includes and abscess, an infected cyst or haemorrhage within a cyst or a necrotic lymph node with central liquification.