Any insight on a dx or ddx?

[CaliMedStudent1]

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Any have some insight into what I should look into for a diagnosis or diff?

White nodule located in b/t palatoglossal and palatopharyngeal arches. Possibly on the tonsil. No specific history given/available other than a recent antibiotic reg (z-pac) for bronchitis.

MDConsult ddx gives me a couple different options.

Tonsillar Carcinoma (SquamosCellC) ~90%
Oral Thrush (maybe due to the z-pac)?
Tonsillolith (tonsil stones)


View attachment nodule.jpg

 

[resxn]

first of all, there is no way that can be diagnosed based on the history and even with the picture you provide. C'mon, you're a med student, you can present far better than this. Age of pt? Smoker? Drinker? Pain in the tonsil? How long's it been there? How was it noticed? Change in size, shape, or other appearance? Tender to palpation? Is it hard or soft? Does it look submucosal or does it look like a foreign body sitting lodged there? Has he ever had tonsiliths before?

Based on what I've got, that IS in the tonsil. My best guess on imaging is a mucocele, but anything you listed above is fair game without having more information. Based on appearance, SCCa is lower on the list.

 

[EBI831]

u know resxn, this is the first time i've noticed ur avatar was someone's brain leaving their head. i just thought it was some kind of grendel like spiky raptor beast with some kind of flame or puff coming out of it's mouth. weird.

 

[ninjapenguin]

u know resxn, this is the first time i've noticed ur avatar was someone's brain leaving their head. i just thought it was some kind of grendel like spiky raptor beast with some kind of flame or puff coming out of it's mouth. weird.

Not just ANYONE'S brain... it's Calvin!! I loved that comic growing up! Better than Charlie Brown, in my opinion.

 

[neutropeniaboy]

Cancer.

No doubt. I've seen it before like this. Probably needs a radical tonsillectomy and at least MRND. I'd even consider adjuvant chemoradiation given aggressive look of the lesion.

 

[Winged Scapula]

Given that the OP has cross-posted this thread in the Dental Forum albeit with slightly different wording which makes it clear that this is seeking medical advice (a TOS violation), I'll close this thread.