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1. Tonsillar fossa mass due to non-Hodgkin's lymphoma. <br> <br>2. Laryngeal penetration. <br> <br>3. Value of phonation. <br>, MedPix™ : 1611 - Medical Image Database and Atlas
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More Like This ? 1. Tonsillar fossa mass due to non-Hodgkin's lymphoma.

2. Laryngeal penetration.

3. Value of phonation.

Topic 1611 - Created: 2001-04-02 08:47:17-04 - Modified: 2004-06-14 21:08:02-04
ACR Index: 7.3

These cases demonstrate the value of distension in performing double contrast pharyngography. In the lateral position, the pharynx is distended by having the patient sing "Eee...". The pharynx is distended in the frontal view by having the patient perform a modified Valsalva maneuver (blowing against closed or pursed lips, whistling).

The main differential diagnosis for a tonsillar mass in an elderly patient is that of squamous carcinoma or lymphoma. Hyperplasia of the palatine tonsils is a frequent finding in the young, but with age, the tonsil usually atrophies.

The pharynx may protrude at sites of weakness. When the tonsil has been removed from the tonsillar fossa, the lateral oropharyngeal wall is weak and only supported by the palatopharyngeus muscle. This may allow bowing in the region of the tonsillar fossa (TF). Weakness in the region of the unsupported thyrohyoid membrane may result in lateral pharyngeal pouches (P).

Contributor Credits

Topic Author(s): Stephen Rubesin, MD
Topic Submitted by: Gastrointestinal Learning File - © ACR - Author Info
Affiliation: ACR Learning File®
Topic approved by: James G. Smirniotopoulos, M.D. - Editor Info
Affiliation: Uniformed Services University

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