FREDERIC B.ASKINMDWILLIAM H.WESTRAMD
AN 86-YEAR-OLD WHITE WOMAN presented to the emergency department with chest pain and shortness of breath. She also reported a recent history of hoarseness, with the sensation that her throat was "closing up." She had a medical history of hypertension, peripheral vascular disease, left ventricular hypertrophy, transient ischemic attacks, osteoporosis, and hypercholesterolemia. An electrocardiogram showed no evidence of ischemia, and her cardiac enzyme levels were normal. A helical computed tomographic scan was negative for pulmonary embolism but revealed a mass in the left side of the neck, which prompted further evaluation of the thyroid gland.
Williamson G, Rao U, Myers EN, Hunt JL. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2003;129(4):486. doi:10.1001/archotol.129.4.486