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Clinical Problem Solving: Pathology
August 16, 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(8):840. doi:10.1001/archoto.2010.118-a

A 58-year-old man presented with a 1-month history of an expanding mass in the left side of his neck and neurologic symptoms. His left-sided otalgia, headache, and odynophagia were initially treated as a temporomandibular joint disorder. He developed hoarseness, a dry cough, left-sided facial numbness, and a rapidly expanding mass in the left side of his neck (4.3 × 3.4 cm on a computed tomographic [CT] scan) and then left-sided ptosis and diplopia. Positron emission tomography (PET) revealed multiple systemic foci of intense tracer uptake. The findings of fine-needle aspiration of the neck node at an outside institution were nondiagnostic; flow cytometry was not performed. The results of a bone marrow biopsy and a lumbar puncture were normal.

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