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Clinical Problem Solving: Pathology
Oct 2012

Pathology Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2012;138(10):977. doi:10.1001/2013.jamaoto.44

A 20-year-old South Asian woman was referred for evaluation of a patient-perceived neck mass. She reported intermittent swelling in the left side of her neck. She was otherwise asymptomatic. Her medical history included IgA deficiency, Raynaud phenomenon, polyarthritis, mild lupus, and purified protein derivative positivity attributed to inoculation with the BCG vaccine. Physical examination revealed no discrete neck mass; however, further inspection demonstrated a 7.0-mm, firm, white, indurated swelling on the dorsum of the tongue. Computed tomography (CT) (Figure 1) showed a 1.0 × 2.0-cm left tracheoesophageal groove mass abutting the thyroid lobe and extending between the esophagus and the trachea, just below the cricoid cartilage. Magnetic resonance imaging (MRI) revealed a hyperintense mass on T2-weighted images, bulging the posterior wall of the trachea (Figure 2).