An Elderly Woman With Stridor

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An Elderly Woman With Stridor Aik Hau Tan, MBBS, Su-Ying Low, BMBCh, FCCP, Issam Al Jajeh, MD  CHEST  Volume 141, Issue 3, Pages 809-813 (March 2012) DOI: 10.1378/chest.11-0537 Copyright © 2012 The American College of Chest Physicians Terms and Conditions

Figure 1 Chest radiograph showing narrowing at the cervical trachea (white arrow). CHEST 2012 141, 809-813DOI: (10.1378/chest.11-0537) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

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 2012 141, 809-813DOI: (10.1378/chest.11-0537) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

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 2012 141, 809-813DOI: (10.1378/chest.11-0537) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

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 2012 141, 809-813DOI: (10.1378/chest.11-0537) Copyright © 2012 The American College of Chest Physicians Terms and Conditions

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 2012 141, 809-813DOI: (10.1378/chest.11-0537) Copyright © 2012 The American College of Chest Physicians Terms and Conditions