[A man from Africa with a swelling in the head and neck region].

A general dental practitioner can, in the daily practice, be confronted with a patient with a swelling in the head and neck region. For such swellings an extensive differential diagnosis exists. Often such a swelling is caused by one or more enlarged lymph nodes due to a bacterial or viral infection. If a swelling in the head and neck region has been present for some time--longer than 4 weeks--then there is a considerable chance, especially in adults, that it is the result of the metastasizing of a malignancy, such as a squamous cell carcinoma in the oral mucosa or another mucosal site in the head and neck region. In addition to lymph node swellings resulting from a malignancy, diseases are now more frequently encountered which were previously uncommon in the Netherlands, due in part to the growing number of people with a non-Western ethnic background. Tuberculosis is such a rare disease, which can in the first instance express itself in the form of a lymph node swelling in the head and neck region.