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Clinical Problem Solving: Pathology
February 15, 2010

Pathology Quiz Case 1

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Copyright 2010 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2010

Arch Otolaryngol Head Neck Surg. 2010;136(2):204. doi:10.1001/archoto.2009.227-a

A 66-year-old woman presented with a 12-month history of progressive intermittent dysphonia. Biopsy specimens obtained from the right supraglottic region at a different hospital had failed to produce a diagnosis. The patient was a heavy smoker who had been diagnosed as having chronic obstructive pulmonary disease and ischemic heart disease, which had required a triple coronary artery bypass. Fiberoptic nasoendoscopy revealed a smooth, partially ulcerated, exophytic lesion located in the right laryngeal ventricle (clinically T2) (Figure 1). A contrast-enhanced computed tomographic scan of the neck demonstrated a soft-tissue mass in the right supraglottic larynx involving the right arytenoepiglottic fold and the false vocal cord (Figure 2and Figure 3). There was no radiologic evidence of nodal disease in the neck. The patient underwent panendoscopy with excision biopsy of the laryngeal lesion.

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