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Clinical Problem Solving: Pathology
March 2004

Pathology Quiz Case 1

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2004;130(3):366. doi:10.1001/archotol.130.3.366

A 58-year-old man presented with a subglottic obstruction that had developed after he underwent a tracheotomy for impending airway obstruction. Endoscopic biopsy specimens from the subglottic region showed normal laryngeal mucosa, stroma, and cartilage. He was a nonsmoker and was systemically well, with no constitutional symptoms.

Examination revealed that the movement of his vocal cords was normal. There was a submucosal fullness in the subglottic region, narrowing his airway, but the mucosa was intact, and there was no palpable cervical lymphadenopathy. Computed tomography of the patient's larynx and neck (Figure 1) showed that the entire cricoid cartilage was expanded circumferentially, with no definite calcification or spiculation. The cricoid enlargement narrowed the subglottic airway from just below the vocal cords to just above the trachea. No enlarged lymph nodeswere noted. A chest x-ray film revealed no abnormalities. Panendoscopic examination confirmed the presence of a circumferential, subglottic, submucosal fullness, and endoscopic biopsy specimens from the postcricoid and subglottic regions revealed no pathologic changes.

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