A 27 -year-old woman with a history of obesity and hypothyroidism presented complaining of 2 days of nonproductive cough and “tongue swelling.” She stated that the swelling was painless and believed that it was at the posterior aspect of her tongue. She reported difficulty lying flat, which she attributed to an inability to get air “into her neck”; she had spent the previous night sleeping sitting upright. She denied fever and exertional dyspnea but endorsed 2 days of nonexertional, pleuritic chest pain. She also reported long-standing rhinorrhea. She had no history of similar episodes and denied recent dental procedures or other trauma to the area. She had no family history of similar problems, was currently unemployed, and was living with her husband. She denied any drug or alcohol use but did smoke one-half pack of cigarettes per day.