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June 1968

The Resident's Page

Arch Otolaryngol. 1968;87(6):680-683. doi:10.1001/archotol.1968.00760060682026

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PATHOLOGIC QUIZ CASE 1  Ronald W. Strahan, MD, and Frederick Fascenelli, MD, Palo Alto, CalifIn 1958 a 56-year-old white man was treated for a nasopharyngeal lymphoepithelioma with 7,139 rads of high voltage x-ray via a 6-cm circular left lateral field that included both eustachian tubes. The patient did well until March 1967 when he developed an upper respiratory infection with a "plugged" feeling in his right ear. The nasopharynx was clear, the neck was free of adenopathy, and the left tympanic membrane was normal. The right ear canal was normal. However, the right tympanic membrane was a deep blue color. Pneumo massage showed the right tympanic membrane to be severely restricted in movement. In the mid portion of the tympanic membrane, near the long process of the malleus, was a light-appearing mass. Audiologic findings are shown in Fig 1.X-ray films of the temporal bones showed no evidence

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