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Case 347.

Ramya Gaddikeri1, Palmi Shah1

  • 1Department of Diagnostic Radiology and Nuclear Medicine, Rush University Medical Center, 1620 W Harrison St, Chicago, IL 60612.

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Summary
This summary is machine-generated.

A 69-year-old woman with a smoking history experienced worsening shortness of breath and voice changes. Pulmonary function tests revealed severe obstruction, and laryngoscopy showed mucosal changes, prompting further CT scan review.

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Area of Science:

  • Pulmonology
  • Otolaryngology
  • Radiology

Background:

  • A 69-year-old woman presented with new-onset dysphonia and progressive shortness of breath.
  • Her medical history included asthma, gastroesophageal reflux disease, and a 40-pack-year smoking history.
  • Yearly lung cancer screening with low-dose CT had been performed since 2019.

Purpose of the Study:

  • To investigate the cause of new-onset dysphonia and shortness of breath in a patient with significant smoking history and underlying lung disease.
  • To evaluate the findings from pulmonary function tests and laryngoscopy in conjunction with serial CT scans.

Main Methods:

  • Clinical examination, including pulmonary function tests (PFTs) and flexible laryngoscopy.
  • Review of serial low-dose computed tomography (CT) screening studies from 2019, 2023, and 2024.
  • Assessment of vocal cord movement and laryngeal mucosa during laryngoscopy.

Main Results:

  • PFTs demonstrated severe obstructive lung disease with air trapping and reduced diffusion capacity.
  • Laryngoscopy revealed pachydermatous changes in the interarytenoid mucosa, suggestive of reflux or chronic infection.
  • CT screening studies were reviewed as part of the diagnostic workup for shortness of breath.

Conclusions:

  • The patient's symptoms were associated with severe obstructive lung disease and laryngeal mucosal changes.
  • Further investigation, including review of serial CT imaging, was part of the diagnostic process.
  • The findings highlight the importance of a multidisciplinary approach in evaluating complex respiratory and voice symptoms.