PATHOLOGIC QUIZ CASE 1
G. Richard Holt, MD; Eric J. Carlson; William E. Davis, MD, Columbia, Mo
A 44-year-old man was admitted to the pulmonary service of a hospital because of fatigue, weight loss, and a chest x-ray film that showed a pulmonary coin lesion on the right side. He also had noted a mass in the left portion of his neck that had increased in size.Results of physical examination disclosed a 3 × 3 cm posterior cervical triangular lymph node that was slightly tender and firm but was not fixed. Chest x-ray film confirmed a pulmonary lesion on the right. A metastatic workup disclosed normal findings. Bronchoscopic biopsy specimens showed only squamous metaplasia. A lymph node biopsy was performed (Fig 1). Following this, otolaryngologic consultation was obtained. Results of head and neck examination were normal, except for the previous biopsy site and edema of the left nasopharyngeal wall,