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January 1984

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol. 1984;110(1):64-67. doi:10.1001/archotol.1984.00800270068020


Donald R. Lewis, MD, Portsmouth, Va  A 56-year-old man noted a nontender right supraclavicular mass six to eight weeks prior to seeking medical attention. He denied having pain or change in size of the mass. He further denied having hoarseness, dysphagia, hemoptysis, or other masses. He had a 60-pack-year history of cigarette smoking that ended in the 1960s. The patient was in general good health and not taking medication. Head and neck examination demonstrated a 2.5 × 3-cm rubbery mobile right posterior cervical triangle mass as well as a 2-cm mobile nontender right submandibular mass. Indirect laryngoscopy-hypopharyngoscopy showed no primary malignancy focus. Needle aspiration biopsies were inconclusive; no malignant cells were noted. After normal barium esophagram and preoperative laboratory examination results were obtained, the patient underwent full endoscopy of the upper aerodigestive tract. Multiple selective biopsy specimens showed only chronic inflammatory changes. Bronchial washings demonstrated no

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