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Radiology Quiz Case 1

Radiology Quiz Case 1 A 66-YEAR-OLD MAN with a 25–pack-year smoking history was seen in 1994 for a complaint of progressive hoarseness over the preceding 10 years. Indirect laryngoscopy revealed the presence of a vocal cord polyp, which was removed with no complications. The patient reported that his hoarseness diminished greatly after this procedure, but then he noted its progressive return and sought medical attention after a period of 7 years. On presentation, he denied dysphagia, dyspnea, cough, sore throat, or weight loss. Physical examination revealed an absence of cervical lymphadenopathy, and a chest x-ray film showed no abnormalities. On laryngoscopy, the left true vocal fold was found to be medially displaced, with a cherry-red mass attached to its undersurface. Both true vocal folds were mobile, and the airway did not appear to be significantly compromised. Computed tomographic imaging of the neck revealed a 5 × 5-mm enhancing soft tissue mass on the undersurface of the left true vocal fold in its anterior third. The overlying thyroid cartilages, the ventricle, and the false cords were all within normal limits (Figure 1). Normal-sized, normal-appearing lymph nodes were present in the normal lymph node–bearing regions. Figure 1. View LargeDownload A biopsy specimen of the mass, which is shown in Figure 2, showed a well-circumscribed submucosal nodule composed of dilated vascular channels (V) surrounded by smooth muscle walls (SM). Figure 2. 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

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Publisher
American Medical Association
Copyright
Copyright © 2002 American Medical Association. All Rights Reserved.
ISSN
0886-4470
eISSN
1538-361X
DOI
10.1001/archotol.128.11.1330
Publisher site
See Article on Publisher Site

Abstract

A 66-YEAR-OLD MAN with a 25–pack-year smoking history was seen in 1994 for a complaint of progressive hoarseness over the preceding 10 years. Indirect laryngoscopy revealed the presence of a vocal cord polyp, which was removed with no complications. The patient reported that his hoarseness diminished greatly after this procedure, but then he noted its progressive return and sought medical attention after a period of 7 years. On presentation, he denied dysphagia, dyspnea, cough, sore throat, or weight loss. Physical examination revealed an absence of cervical lymphadenopathy, and a chest x-ray film showed no abnormalities. On laryngoscopy, the left true vocal fold was found to be medially displaced, with a cherry-red mass attached to its undersurface. Both true vocal folds were mobile, and the airway did not appear to be significantly compromised. Computed tomographic imaging of the neck revealed a 5 × 5-mm enhancing soft tissue mass on the undersurface of the left true vocal fold in its anterior third. The overlying thyroid cartilages, the ventricle, and the false cords were all within normal limits (Figure 1). Normal-sized, normal-appearing lymph nodes were present in the normal lymph node–bearing regions. Figure 1. View LargeDownload A biopsy specimen of the mass, which is shown in Figure 2, showed a well-circumscribed submucosal nodule composed of dilated vascular channels (V) surrounded by smooth muscle walls (SM). Figure 2. View LargeDownload What is your diagnosis?

Journal

Archives of Otolaryngology - Head & Neck SurgeryAmerican Medical Association

Published: Nov 1, 2002

Keywords: diagnostic radiologic examination,radiology specialty

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