04 October 2006 ENT Appointment

Arrived at Eastern Virginia Ear, Nose & Throat Specialists on time and met Dr. Richard Debo. We talked for a while and he informed me that he wanted to run a tube with a scope up my nose and down my esophagus to check for any tumors or anything unusual. First they sprayed some kind of numbing stuff down my throat so I wouldn't feel much, then he ran the scope up my nose and all the way down. I was watching with him on a monitor of my internal workings. Boy was that weird. Everything looked normal so he decided to do a biopsy of the lump on my neck. Biopsy
He took two biopsy's and said he would have the results in two days.
Here is a copy of the email he sent me following our appointment:

Here are the notes Dr. Debo sent me in an email:

Dear Dave,

As per your request I am writing to summarize our discussions from today's appointment. You presented to the office today for evaluation of a three month history of a left neck mass which has not responded to treatment with a first line antibiotic (Amoxicillin). You are a recently reformed smoker having formerly consumed one pack per day for the previous 20 years. The CT scan you brought with you revealed a well circumscribed mass in the left neck which touches the jugular vein, carotid artery and the parotid gland. The differential diagnosis at this point includes both benign and malignant possibilities. More commonly these things turn out to be benign tumors like branchial cleft cysts, enlarged lymph nodes, or infections. I am concerned however because of your past tobacco use about the possibility of a malignancy such as a squamous cell carcinoma, lymphoma or a thyroid neoplasm. After obtaining a through history and physical exam on you in the office we then performed a fine needle aspiration(FNA) of the neck mass to try to obtain cells for diagnostic studies. This may help to guide our further management. I placed you on another stronger antibiotic while we await the results of the FNA to see if we can shrink the mass down. I will see you back in the office in one week to review the biopsy results and to plan our next steps. I hope this helps you out. If you have other more specific questions please feel free to call me in the office I'll try to get right back to you.

R. F. Debo, M.D.,F.A.C.S.