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Clinical Problem Solving: Pathology
August 17, 2009

Pathology Quiz Case 1

Author Affiliations
 

JULIA CIEZZONIMD

Arch Otolaryngol Head Neck Surg. 2009;135(8):832. doi:10.1001/archoto.2009.82-a

A 57-year-old woman presented with a 4-month history of an intractable cough. She had recently been diagnosed as having non–small cell lung cancer (stage IIIb) and had undergone a lobectomy, with neoadjuvant chemoradiation therapy. The cough, which was nonproductive and triggered by phonation, persisted despite a course of oral steroids and a proton pump inhibitor. Flexible fiberoptic laryngoscopy revealed a 2- to 3-mm mucosa-covered lesion situated along the left laryngeal surface of the epiglottis. The lesion had initially been noted on examination 2 years earlier; it was believed to represent a benign inclusion cyst and was not biopsied at that time. It had grown slightly since then, and the patient opted for surgical removal, hoping that elimination of the lesion would ameliorate her cough.

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