Head & Neck Case Review 2021-10

Head & Neck Case Review

October, 2021


An adult woman with a significant smoking history presented to the emergency department with chronic unilateral otalgia and worsening odynophagia causing decreased appetite and weight loss. The patient denied fevers or B symptoms. Physical exam demonstrated a firm, exophytic, non-ulcerated mass in the palatine tonsil. CT scan showed a tonsillar mass with bilateral lymphadenopathy throughout the neck. The patient underwent bilateral tonsillectomy.



Q1. What is the diagnosis?

  • A. Extramedullary plasmacytoma
  • B. Systemic lupus erythematosus
  • C. T. pallidum infection
  • D. Granulomatosis with polyangiitis

Q2. What is the most specific confirmatory test?

  • A. c-ANCA
  • B. Flow cytometry, serum protein electrophoresis and bone marrow biopsy
  • C. Direct immunofluorescence
  • D. Serum RPR and VDRL
  • E. Serum RPR and FTA-ABS



Igor Damasceno Vidal, MD, PGY-2 resident
Pathology Residency Program
University of Alabama at Birmingham School of Medicine

Manuel Lora Gonzalez, MD, Assistant Professor
Department of Pathology
University of Alabama at Birmingham Hospital & School of Medicine