PMC7422345_01
Axial nonenhanced computed tomography scan of the neck. (a) Necrotic cervical lymph nodes at level IIa and (b) submucosal edema of the supraglottis.
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An urgent CT scan was arranged (Figure 1).
Microscopic features of arytenoid tissue samples. (a) Arytenoid mucosa showing large nests of malignant cells in the lamina propria with normal overlying surface epithelium (H&E 100x). (b) High power image showing small nests of cells plugging lymphatics in the lamina propria. Note the variability in nuclear size, irregularly shaped nuclei, and prominent nucleoli typical of ovarian serious carcinoma (H&E 400x). (c) Immunohistochemical stain for Pax8, showing nuclear positivity in the tumor cells, consistent with metastatic serous carcinoma (Pax8 400x).
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fig2
Despite high-dose steroid therapy, the laryngeal edema rapidly progressed and she was consented for direct laryngoscopy and biopsy of the supraglottis (Figure 2).