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August 1969

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Arch Otolaryngol. 1969;90(2):228-231. doi:10.1001/archotol.1969.00770030230029

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PATHOLOGIC QUIZ CASE 1  Charles N. Ford, Jr., MD, DetroitA 73-year-old white woman complained of a 24-hour history of hemoptysis. She had noticed a change in her voice over the preceding three to four months and mentioned that her face had become swollen during the past week. Six years ago she had undergone a left nephrectomy for a cancer. The past history further contributed that five months prior to the present hospital admission she was found to have had a mass in the left neck. A thyroid scan at that time showed negligible uptake over the left lobe. The patient then refused hospitalization and was lost to follow-up.Examination revealed an apprehensive patient with marked venous engorgement of the left neck and generalized plethora and edema of the head and neck. The left pupil was constricted and reacted sluggishly to light. Indirect laryngoscopy revealed paralysis of the left vocal

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