PATHOLOGIC QUIZ CASE 1
Stacey E. Mills, MD, Charlottesville
A 55-year-old man, formerly a construction worker, entered his local emergency room complaining of recent progressive hoarseness. He had a long history of cigarette smoking and alcohol abuse.The patient was thin and appeared chronically ill and older than his stated age. His speech was labored and just above a whisper; there were bilateral pulmonary rales. Indirect laryngoscopy revealed a polypoid, granular, ulcerated lesion, involving much of the posterior portion of the larynx. A presumptive clinical diagnosis of squamous cell carcinoma was made, and a biopsy was subsequently performed. Figures 1 and 2 are representative photomicrographs of the biopsy specimen.Four months later, the examining laryngologist experienced fever, night sweats, weight loss, and a nonproductive cough.What is your diagnosis?
PATHOLOGIC QUIZ CASE 2
Robert E. Fechner, MD