Medical Images
A Stony Gland!
A 35-year-old man presented with a swelling below the jaw on the right side. The swelling increased on taking food. On examination, a 3 × 3 cm firm swelling was seen in the right submandibular region (Figure 1). The swelling was bidigitally palpable. The computed tomography scan of the swelling revealed an enlarged submandibular gland with dense white opacities suggestive of multiple stones (Figure 2). A diagnosis of submandibular sialolithiasis was made and the gland was removed surgically. The patient was asymptomatic at 4-month follow-up.Recurrent Laryngeal Papillomatosis
A 49-year-old woman presented with a complaint of hoarseness for 3 months. Laryngeal examination showed an irregular growth on the surface of the left vocal cord (Figure 1). The rest of the physical examination was normal. The patient had a history of similar complaints in the past and had 2 operations. A provisional diagnosis of recurrent respiratory papillomatosis was made, which was confirmed on histopathological examination of the specimen (Figure 2). The growth was removed using carbon dioxide laser, and the patient is asymptomatic at 11 months of follow-up.Plummer-Vinson Syndrome
A 32-year-old woman presented with a history of fatigability for 9 months and progressive difficulty in swallowing solids for 2 months. On examination she was pale and had glossitis, cheilitis (Figure), and koilonychia. Blood analysis revealed microcytic hypochromic anemia with anisocytosis, a hemoglobin level of 6 g/dL (normal, 12-14 g/dL), mean corpuscular volume of 65 fL (normal, 80-95 fL), mean corpuscular hemoglobin of 19 pg/dL (normal, 27-32 pg/dL), serum iron level of 22 μg/dL (normal, 50-140 μg/dL), serum ferritin level of 14 ng/mL (normal, 25-250 ng/mL), and total iron-binding capacity of 495 μg/dL (normal, 245-450 μg/dL).
