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August 1988

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol Head Neck Surg. 1988;114(8):920-923. doi:10.1001/archotol.1988.01860200104030

PATHOLOGIC QUIZ CASE 1  P. L. Kemberling, MD, ChicagoAn 85-year-old woman complained of a painless, gradually enlarging skin lesion of the right neck that had been present for several months. On examination, the solitary lesion was smooth, nontender, and purplish-red, and measured 1.5 cm in diameter (Fig 1). An excisional biopsy was done(Fig 2). Electron microscopy was performed as well (Fig 3). A neck dissection was recommended by the surgeon; however, the patient refused, and instead wide excision and lymph node sampling was performed. No residual disease was found.Three months later, two large, non-tender right cervical lymph nodes were palpated, and a right-modified radical neck dissection was performed. The histologic appearance of ten of the 40 nodes is shown in Fig 4.What is your diagnosis?

PATHOLOGIC QUIZ CASE 2  Richard M. Rosenfeld, MD; William Lawson, MD, DDS; Hugh F. Biller, MD, New YorkA 77-year-old