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Clinical Problem Solving: Pathology
November 2003

Pathology Quiz Case

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2003;129(11):1243. doi:10.1001/archotol.129.11.1243

A 52-YEAR-OLD MAN underwent radiation therapy 2 years prior to presentation for a stage I laryngeal cancer involving the subglottic anterior commissure. An emergent tracheotomy was performed for airway obstruction. He had a history of long-term tobacco use and alcohol abuse. Direct laryngoscopy and biopsy revealed a large ulcerative polypoid mass involving the glottis and supraglottic areas. Representative hematoxylin-eosin–stained sections of the biopsy specimen are shownin Figure 1 (black arrow indicates spindle cell component; white arrow, squamous cell component [original magnification ×100]) and Figure 2 (arrows indicate spindle cells [original magnification ×400]). Immunohistochemical analysis of the specimen (Figure 3) revealed that its cells were reactive for epithelial antigens (arrow indicates positive staining with high-molecular-weight keratin).

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