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Clinical Problem Solving: Pathology
June 2013

Pathology Quiz Case 1

Author Affiliations
 

SECTION EDITOR: EDWARD B. STELOW, MD

JAMA Otolaryngol Head Neck Surg. 2013;139(6):649. doi:10.1001/jamaoto.2013.3234a

A 57-year-old woman presented with a 2-year history of chronic cough. Onset was associated with flulike symptoms. Her cough worsened, and she started to have difficulty in airway functioning and dysphagia. She denied any hoarseness. A physical examination showed that she was in no apparent distress. Her voice was normal. Flexible fiber-optic laryngoscopy showed a large, posterior, broadly based interarytenoid mass significantly obstructing the posterior glottis, splaying open the arytenoids (Figure 1). The vocal cords were mobile. Computed tomographic imaging of the neck showed a soft-tissue lesion in the larynx obstructing the airway and bilateral level II and III lymphadenopathy. Computed tomographic imaging of the abdomen and pelvis showed hypodense liver lesions.

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