FREDERIC B.ASKINMDWILLIAM H.WESTRAMD
A 10-YEAR-OLD GIRL with no previous medical or surgical history presented with an episode of exercise-induced stridor that had developed while she was playing soccer. The presumptive diagnosis of exercise-induced asthma was made, but the patient had only a limited response to bronchodilators. After a short period of rest her stridor improved, but careful examination revealed a very mild, though persistent, expiratory stridor. Neck x-ray films revealed no abnormalities. Flexible bronchoscopy revealed mild subglottic asymmetry. A computed tomographic scan of the neck and chest suggested the presence of a right-sided tracheal mass approximately 3 cm below the vocal folds (Figure 1). Direct laryngoscopy and rigid bronchoscopy revealed a 1 × 1.5-cm, smooth, yellow mass in the lateral aspect of the right side of the trachea, just below the cricoid ring (Figure 2). A biopsy was performed and the pathological findings are shown in Figure 3 and Figure 4.
Prasad M, Keller JL. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2002;128(5):594. doi: