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Clinical Problem Solving: Radiology
January 2005

Radiology Quiz Case 2

Author Affiliations

The Netherlands Cancer Institute–Antoni van Leeuwenhoek Hospital, Amsterdam



Arch Otolaryngol Head Neck Surg. 2005;131(1):74. doi:10.1001/archotol.131.1.74

A 63-year-old man presented with hoarseness and dysphagia. During his previous visits, for the same symptoms, examinations, including several imaging studies, had revealed no abnormalities. Because of the persistent symptoms and repeated negative endoscopic findings, as well as a mediastinal enlargement that had been seen on the last chest x-ray film, another computed tomographic (CT) scan of the patient’s neck and chest was performed. The CT scan of the chest showed soft-density lesions in the sternum, lung apices, multiple ribs, and vertebral bodies. Also, a CT scan of the neck showed a soft-density mass in the paralaryngeal space and thyroid lamina on the left side (Figure 1 and Figure 2).