A 72-year-old woman has had difficulty with vision in her right eye for 3 months. She also has pain in the right upper chest. The findings on physical examination include unilateral enophthalmos, miosis, anhidrosis, and ptosis on the right side of her face. A chest radiograph shows right upper lobe opacification and bony destruction of the right first rib. Which of the following conditions is most likely to be present in her?
Correct Answer: Bronchogenic carcinoma
Description: Horner syndrome is a result of sympathetic autonomic nerve involvement by invasive pulmonary carcinoma. Such a neoplasm in this location with these associated findings is called a Pancoast tumor. Infectious processes such as pneumonia are unlikely to impinge on structures outside the lung. Bronchiectasis destroys bronchi within the lung. Sarcoidosis can result in marked hilar adenopathy with a mass effect, but involvement of the peripheral nervous system is unlikely. Likewise, tuberculosis is a granulomatous disease that can lead to hilar adenopathy, although usually without destruction of extrapulmonary tissues.
Category:
Pathology
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