65 years old male patient presented with c/o
1. Sticky sensation in the throat - 6 months
2. Difficulty in swallowing - 2 months
3. Change in voice - 1 month
4. Breathlessness - 15 days
Sticky sensation was present on the right side of the throat. It was more for solids.
This sticky sensation gradually progressed to difficulty in swallowing
Change in voice started suddenly 1 month back.
Breathlessness started 15 days back. Initially it was more on exertion. Now it is so bad that even simple tasks makes the patient feel breathless. It is always associated with noisy wheeze.
Patient was treated for pulmonary tuberculosis 15 years back.
Patient gave h/o fever which lasted for 10 days 8 months back.
Laryngoscopic examination showed: A proliferative mass seen occupying the whole of right pyriform fossa. It was also found involving the epiglottis, arytenoid and aryepiglottic fold on the right side. Right vocal cord was found to be fixed.
Figure showing the mass
CT scan showed:
Mass seen involving the right pyriform fossa extending to involve the aryepiglottic fold and arytenoid cartilage on the right side.
Reformatted Ct images were taken:
AP view showed the lower extent of the mass as shown below.
Three dimensional CT imaging was also performed:
Biopsy from the lesion was taken using video endoscopic procedure:
Figure showing biopsy being taken
Biopsy was reported as Non Hodgkin's lymphoma.
Squamous cell carcinoma is the most common malignancy in this area. It is pretty rare for lymphoma to occur here.
This case is being reported for its rarity.
Patient was treated with full course of radiotherapy.
Whole body scan was performed. There was no evidence of hepatosplenomegaly.
No other nodes were involved.