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January 1972

The Resident's Page

Author Affiliations

1721 Pine St, Philadelphia 19103; The Methodist Hospital, Houston 77025

Arch Otolaryngol. 1972;95(1):88-91. doi:10.1001/archotol.1972.00770080136017

PATHOLOGIC QUIZ CASE 1  Richard B. Dawson, MD, Columbia, MoA 12-year-old white boy had a 1½-month history of a polyp in the left nares and a three-week history of nasal obstruction and bleeding. The diagnosis of Down's syndrome had been made in 1964 and no nasal mass was noted at that time. Physical examination revealed a reddish polyp with a smooth surface extending into the vestibule and occluding the internal nares. A small amount of purulent material was located around the edge of this mass. A culture revealed Diplococcus pneumoniae. X-ray films showed an increased density in the left nares with normal paranasal sinuses. At the time of surgery, the above tissue extended to the left choana, occluding this area. The appearance, by mirror, was extremely dark black over the left choanal end of the tissue. After removal of the mass, the attachment of which seemed to come from