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An Elderly Woman With Stridor

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1 An Elderly Woman With Stridor
Aik Hau Tan, MBBS, Su-Ying Low, BMBCh, FCCP, Issam Al Jajeh, MD  CHEST  Volume 141, Issue 3, Pages (March 2012) DOI: /chest Copyright © 2012 The American College of Chest Physicians Terms and Conditions

2 Figure 1 Chest radiograph showing narrowing at the cervical trachea (white arrow). CHEST  , DOI: ( /chest ) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

3 Figure 2 CT scan showing a diffusely enlarged thyroid gland and narrowing of the trachea. Subtle nonspecific indentation of the left lateral wall of the trachea is seen (arrows). Definite tumor infiltration at the same area was later demonstrated on bronchoscopy. CHEST  , DOI: ( /chest ) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

4 Figure 3 Spirometry showing evidence of variable extrathoracic airways obstruction. LLN=lower limit of normal; %Chng=% change; %Pred=% predicted; Post-Bronch=postbronchodilator response; Pre-Bronch=prebronchodilator response; Pred=predicted. CHEST  , DOI: ( /chest ) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

5 Figure 4 Endoscopic images. A, Edema of the vocal cords (black arrow). B, Tumor infiltration of the left lateral wall of the trachea (white arrow). CHEST  , DOI: ( /chest ) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

6 Figure 5 Histologic specimens from tracheal biopsies. A, Respiratory mucosa, diffusely infiltrated by large atypical cells (hematoxylin and eosin, original magnification ×10). B, The same tissue with nearly exclusive composition of large B cells (CD20 immunohistochemical, original magnification × 10). CHEST  , DOI: ( /chest ) Copyright © 2012 The American College of Chest Physicians Terms and Conditions


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