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Article
November 1979

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Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol. 1979;105(11):684-687. doi:10.1001/archotol.1979.00790230054011
Abstract

PATHOLOGIC QUIZ CASE 1 

H. George Levy, MD, Detroit  A 73-year-old man had a six-week history of difficulty swallowing. Attempts at eating were associated with extreme coughing and regurgitation of food into the nasopharynx and through the nose. He had a stroke in 1968 for which he was hospitalized. Aphasia was the primary result. He had recovered completely from this between 1968 and 1976.Results of physical examination showed atrophy of the left trapezius and sternocleidomastoid muscles, paralysis of the left vocal cord, and decreased reflexes of the soft palate. The ears and nasopharynx were normal. The left side of the soft palate was firm to palpation and there was a small (0.3-cm) mucosal irregularity just to the left of the uvula. There was no palpable cervical lymphadenopathy. Tissue was removed from the mucosal irregularity for biopsy. A photomicrograph of the tissue specimen is shown in Fig 1. Skull films,

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