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Pathology Quiz Case 2

Pathology Quiz Case 2 A 47-year-old woman presented with a 2-month history of a left infra-auricular mass with mild tenderness. She was otherwise healthy and had no family history of cancer. Physical examination demonstrated a 2.0 × 2.0-cm, firm, fixed mass over the left parotid region, an intact oral mucosa, and no palpable lymphadenopathy. Fiberoptic laryngoscopy revealed no visible tumor in the larynx or the pharynx. Computed tomography of the patient's face revealed at least 4 enhanced nodular lesions in the superficial and deep lobes of the left parotid gland, with the largest one measuring 2.3 cm in greatest dimension (Figure 1). The results of laboratory investigations were normal. View LargeDownload Figure 1. A total parotidectomy was performed, with preservation of the facial nerve. Intraoperatively, the surgical specimen of the superficial lobe of the parotid gland contained 3 well-defined, grayish brown tumors without capsulization, with the largest one measuring 2.1 × 1.8 × 1.4 cm. One of the tumors showed cystic change. Another well-defined, grayish brown nodule, measuring 0.4 × 0.4 × 0.3 cm, was found in the deep lobe of the parotid gland (Figure 2). Microscopic examination showed multiple nodules of intensely eosinophilic cells without a fibrous capsule in the superficial and deep lobes of the parotid gland. The parenchyma of the parotid gland, including serous acini, ducts, and adipose tissue, was interspersed among the nodules (Figure 3). A microscopic focus of an incipient nodule of a salivary gland lobule is shown in Figure 4. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. 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 2

Abstract

A 47-year-old woman presented with a 2-month history of a left infra-auricular mass with mild tenderness. She was otherwise healthy and had no family history of cancer. Physical examination demonstrated a 2.0 × 2.0-cm, firm, fixed mass over the left parotid region, an intact oral mucosa, and no palpable lymphadenopathy. Fiberoptic laryngoscopy revealed no visible tumor in the larynx or the pharynx. Computed tomography of the patient's face revealed at least 4 enhanced nodular...
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Publisher
American Medical Association
Copyright
Copyright © 2012 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archoto.2012.289a
Publisher site
See Article on Publisher Site

Abstract

A 47-year-old woman presented with a 2-month history of a left infra-auricular mass with mild tenderness. She was otherwise healthy and had no family history of cancer. Physical examination demonstrated a 2.0 × 2.0-cm, firm, fixed mass over the left parotid region, an intact oral mucosa, and no palpable lymphadenopathy. Fiberoptic laryngoscopy revealed no visible tumor in the larynx or the pharynx. Computed tomography of the patient's face revealed at least 4 enhanced nodular lesions in the superficial and deep lobes of the left parotid gland, with the largest one measuring 2.3 cm in greatest dimension (Figure 1). The results of laboratory investigations were normal. View LargeDownload Figure 1. A total parotidectomy was performed, with preservation of the facial nerve. Intraoperatively, the surgical specimen of the superficial lobe of the parotid gland contained 3 well-defined, grayish brown tumors without capsulization, with the largest one measuring 2.1 × 1.8 × 1.4 cm. One of the tumors showed cystic change. Another well-defined, grayish brown nodule, measuring 0.4 × 0.4 × 0.3 cm, was found in the deep lobe of the parotid gland (Figure 2). Microscopic examination showed multiple nodules of intensely eosinophilic cells without a fibrous capsule in the superficial and deep lobes of the parotid gland. The parenchyma of the parotid gland, including serous acini, ducts, and adipose tissue, was interspersed among the nodules (Figure 3). A microscopic focus of an incipient nodule of a salivary gland lobule is shown in Figure 4. View LargeDownload Figure 2. View LargeDownload Figure 3. View LargeDownload Figure 4. What is your diagnosis?

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: May 1, 2012

Keywords: computed tomography,cancer,physical examination,cysts,neoplasms,parotid gland,parotidectomy,fiberoptic laryngoscopy,parenchyma,salivary glands,facial nerve,oral mucous membrane,pharynx,adipose tissue,larynx

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