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May 1989

Resident's Page

Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol Head Neck Surg. 1989;115(5):636-639. doi:10.1001/archotol.1989.01860290094029

PATHOLOGIC QUIZ CASE 1  Elliot M. Heller, MD; Gurdip S. Sidhu, MD; David Kaufman, MD, New YorkA 36-year-old man was referred for evaluation of a white tongue lesion that had been present for several weeks. The patient gave a history of intravenous drug abuse and was seropositive for the human immunodeficiency virus (HIV) antibody, but had not demonstrated any clinical signs of the acquired immunodeficiency syndrome (AIDS) except for chronic lymphadenopathy.Physical examination revealed a series of slightly raised, white plaques on the lateral surface of the tongue (Fig 1). The lesions were not tender, nor did they rub off.An excisional biopsy of one of these plaques was performed with the patient under local anesthesia. Histologic sections of the lesion are shown in Figs 2 and 3. Electron microscopy was performed on one of the sections, which is shown in Fig 4.What is your diagnosis?