Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 14-Day Trial for You or Your Team.

Learn More →

Pathology Quiz Case 1

Pathology Quiz Case 1 A 24-year-old woman presented to the emergency department with a 1-week history of shortness of breath at rest. She also had a 3-month history of odynophagia, and her voice had become increasingly hoarse. On physical examination, no intraoral masses or lesions were seen or palpated. The patient's neck was soft and flat, with no adenopathy. There was soft inspiratory stridor at rest. Her voice was clear, although it had a slightly harsh quality. Flexible fiberoptic laryngoscopy demonstrated a large exophytic fleshy mass emanating from the right arytenoid. The mass obstructed the laryngeal inlet, obscuring the true vocal cords (Figure 1). Figure 1. View LargeDownload A computed tomographic scan demonstrated a large mass with heterogeneous enhancement, measuring 2.4 × 2.1 × 1.7 cm, centered in the supraglottic airway. The mass crossed the midline and narrowed the glottic aperture (Figure 2). The patient was taken to the operating room for laryngoscopy and biopsies. There was a soft verrucous mass that originated from the right arytenoid. The right true vocal fold was not involved. Histopathologic analysis of the specimens revealed that the overlying squamous epithelium was benign, but the subepithelial connective tissue contained a diffuse proliferation of primitive-appearing spindled or round cells with scant cytoplasm. There were focal spindle cells with bipolar eosinophilic cytoplasm and alternating hypocellular and hypercellular areas. Nuclei were ovoid to irregular, some with distinct nucleoli (Figure 3). Immunostaining was negative for AE1/AE3, 1A4α, and CD99 but was uniformly positive for desmin, myogenin (Figure 4), and myoD1. Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. View LargeDownload What is your diagnosis? http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Otolaryngology - Head & Neck Surgery American Medical Association

Pathology Quiz Case 1

Download PDF
1 page

Pathology Quiz Case 1

Abstract

A 24-year-old woman presented to the emergency department with a 1-week history of shortness of breath at rest. She also had a 3-month history of odynophagia, and her voice had become increasingly hoarse. On physical examination, no intraoral masses or lesions were seen or palpated. The patient's neck was soft and flat, with no adenopathy. There was soft inspiratory stridor at rest. Her voice was clear, although it had a slightly harsh quality. Flexible fiberoptic laryngoscopy...
Loading next page...
 
/lp/american-medical-association/pathology-quiz-case-1-7Yt5Bqmbhi

References (52)

Publisher
American Medical Association
Copyright
Copyright © 2011 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archoto.2011.71-a
Publisher site
See Article on Publisher Site

Abstract

A 24-year-old woman presented to the emergency department with a 1-week history of shortness of breath at rest. She also had a 3-month history of odynophagia, and her voice had become increasingly hoarse. On physical examination, no intraoral masses or lesions were seen or palpated. The patient's neck was soft and flat, with no adenopathy. There was soft inspiratory stridor at rest. Her voice was clear, although it had a slightly harsh quality. Flexible fiberoptic laryngoscopy demonstrated a large exophytic fleshy mass emanating from the right arytenoid. The mass obstructed the laryngeal inlet, obscuring the true vocal cords (Figure 1). Figure 1. View LargeDownload A computed tomographic scan demonstrated a large mass with heterogeneous enhancement, measuring 2.4 × 2.1 × 1.7 cm, centered in the supraglottic airway. The mass crossed the midline and narrowed the glottic aperture (Figure 2). The patient was taken to the operating room for laryngoscopy and biopsies. There was a soft verrucous mass that originated from the right arytenoid. The right true vocal fold was not involved. Histopathologic analysis of the specimens revealed that the overlying squamous epithelium was benign, but the subepithelial connective tissue contained a diffuse proliferation of primitive-appearing spindled or round cells with scant cytoplasm. There were focal spindle cells with bipolar eosinophilic cytoplasm and alternating hypocellular and hypercellular areas. Nuclei were ovoid to irregular, some with distinct nucleoli (Figure 3). Immunostaining was negative for AE1/AE3, 1A4α, and CD99 but was uniformly positive for desmin, myogenin (Figure 4), and myoD1. Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. View LargeDownload What is your diagnosis?

Journal

Archives of Otolaryngology - Head & Neck Surgery – American Medical Association

Published: Jun 20, 2011

Keywords: neck,dyspnea,immunohistochemistry,biopsy,inspiration,physical examination,heterogeneity,hoarseness,arytenoid cartilage,cell nucleus,connective tissue,cytoplasm,desmin,hyperplasia,laryngoscopy,myogenin,operating room,vocal folds,voice,glottis,larynx,swallowing painful,stridor,flexible laryngoscopy,epithelium, squamous,emergency service, hospital

There are no references for this article.