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Pulmonary puzzle
Right vocal cord paralysis and mediastinal lymphadenopathy
  1. Michael Boyd,
  2. Subramanian Malaisamy,
  3. Susanti Ie,
  4. Edmundo Rubio
  1. Virginia Tech Carilion School of Medicine, Section of Pulmonary, Critical Care, Environmental, and Sleep Medicine, Carilion Clinic, Virginia, USA
  1. Correspondence to Dr Michael Boyd, Virginia Tech Carilion School of Medicine, Section of Pulmonary, Critical Care, Environmental, and Sleep Medicine, Carilion Clinic, 1906 Belleview Ave, Roanoke, VA 24014, USA; mbboyd{at}carilionclinic.org

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Case presentation

A non-smoking 45-year-old white man presented with a globus sensation worsened by lying down, with no complaints of hoarseness or dysphonia. He denied fever, fatigue, cough, chest pain, sweats, weight loss, reflux, arthralgias, myalgias and rash. He also denied exposure to asbestosis, beryllium, silica, HIV or tuberculosis, but he reported a recent cat bite. Physical examination revealed normal vital signs, no cervical or supraclavicular lympadenopathy and a normal cardiorespiratory system. He was referred to the otolaryngology department. Laryngoscopy revealed right vocal cord paralysis. A CT scan of the neck/chest identified diffuse mediastinal lymphadenopathy without parenchymal changes (figures 1 and 2).

Figure 1

CT scan of high right paratracheal lymph node.

Figure 2

CT …

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Footnotes

  • Conflict interests None.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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