Step 1

Pathology 18

A previously healthy 4-year-old boy with Down syndrome is brought to the physician by his mother because of a foul-smelling discharge from the right nostril for the past 2 weeks. In this period, his mother has noticed the patient has had loud breathing while inhaling which was not present before. His temperature is 37°C (98.6°F), pulse is 90 beats/min, respirations are 22/min, and blood pressure is 90/60 mm Hg. Physical examination shows malodorous, grey discharge in the right nasal cavity. Endoscopic examination of the nose confirms the diagnosis.

Which of the following is the most likely diagnosis?

  • A) Allergic rhinitis
  • B) Foreign body
  • C) Juvenile nasopharyngeal angiofibroma
  • D) Nasal hematoma
  • E) Nasopharyngeal carcinoma


Neil Deot


Dr. Ted O'Connell

Last updated

Jun 13, 2022


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