A patient presents with a swelling in the submandibular area that specifically worsens during meals. What is the most likely diagnosis?

Correct answer: C. Submandibular salivary gland obstruction (sialolithiasis)

• A. Incorrect. Lymphadenopathy does not characteristically swell during mealtimes.
• B. Incorrect. Cellulitis presents with diffuse erythema, warmth, and fever — and does NOT specifically worsen with meals.
• C. CORRECT. Swelling that worsens specifically during meals is pathognomonic for salivary gland obstruction (sialolithiasis). Eating stimulates salivary secretion; when the duct is blocked (usually by a calculus in Wharton's duct), the gland cannot drain and swells painfully. Symptoms subside between meals as salivary stimulation decreases.
• D. Incorrect. Salivary gland neoplasms typically present as painless, slow-growing masses not correlated with meals.