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Feeling something stuck in throat. Phlegm come out after coughing. What is causing this?

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ENT Specialist
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Hi,
I am really scared. For months I've felt like there was literally something "stuck" in my throat. I've tried to cough it up but only phlegm would come out. Today I coughed up what I think this "thing" is. It literally looks like a raw piece of meat or raw piece of chicken. It is approximately have the size of my finger nail on my pinky finger. Have I just coughed up a tumor or polyp of some sort? I'd like to post a photo of it please. What could this be?
Posted Sat, 16 Mar 2013 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Sumit Bhatti 9 hours later
Hi,

Thank you for your query.

1. This does seem to be a small bit of lymphoid tissue (which is abundant in the throat) coughed up.

2. The simplest way forward is to get a Videolaryngoscopy and nasal endoscopy done to identify the source.

3. It looks benign so there is no cause for worry.

Hope this answers your query. Should you have any additional concerns, I will be glad to assist you further.

Regards
Above answer was peer-reviewed by
 
Follow-up: Feeling something stuck in throat. Phlegm come out after coughing. What is causing this? 4 hours later
Hi,
Thanks for your reply.

How can you tell this is benign?

Could this be a piece of my tonsils (I have never had mine removed) or could this be a polyp?

Have you ever had a patient that coughed up lymphoid tissue and if so what is typically the cause?

I have had leukemia (CML) when I was 19 years old (I'm not 38). I am very paranoid that coughing up this tissue is a symptom of some type of cancer. Is this at all possible to be a symptom of some other type of cancer?

Thank you.
 
 
Answered by Dr. Sumit Bhatti 22 minutes later
Hi,

Thank you for writing back.

1. A malignant tissue would have been accompanied by a lot of bleeding. So would tonsillar tissue. A polyp would not be accompanied by a significant bleeding.

2. Coughing up a piece of tissue is rare.

3. There is an option of sending this bit of tissue for a Histopathological examination (HPE) if you have not discarded it or taking a biopsy of the source (if it can be identified on endoscopy).

4. Your history of CML changes the outlook a bit. There is a possibility of a second primary cancer, and only a regular follow up can detect this early. However, this remains a possibility and may not happen.

5. Two decades ago, tumor markers, imaging such as PET Scans were not widely used. This time, you can use these diagnostic technologies to your advantage.

Hope this answers your query. Should you have any additional concerns, I will be glad to assist you further.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feeling something stuck in throat. Phlegm come out after coughing. What is causing this? 2 hours later
Hi,
When I coughed up the tissue, there was some blood on the actual piece of tissue/object itself and then I gargled with water after and there was a very small amount of blood in the water. So small in fact that I was not sure if there was blood in the gargled up water but I do believe there was. After that, there was nothing. No coughing up any blood after or anything.

I have had phlegm for the last 3 months and the object stuck throat feeling. I normally very rarely produce phlegm that gives me the urge to cough and when it has happened in the past, I've usually had a cold. So it was unusual for me to cough up phlegm for the last 3 months. This morning (now that the tissue/object is gone) I no longer feel like there's something stuck in my throat, the phlegm is gone and I have not had the urge to cough anything out.

May I ask when you first said it looks benign, was this because the tissue is pink and healthy looking or some other reason you thought it could be benign?

I did keep the piece of coughed up tissue/object and I will take it for HPE.
 
 
Answered by Dr. Sumit Bhatti 2 hours later
Hi,

Thank you for writing back.

1. Scanty bleeding is a good sign that the pathology is benign.

2. A Videolaryngoscopy earlier to this episode would have been ideal. It seems that this tag of tissue was the cause of your symptoms.

3. Yes, the tissue is pink, healthy looking. Normal lymphoid tissue is delicate but not friable.

4. An HPE will give an accurate diagnosis. Send it as soon as possible.

Hope this answers your query. Should you have any additional concerns, I will be glad to assist you further.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Feeling something stuck in throat. Phlegm come out after coughing. What is causing this? 49 minutes later
If I may ask one more question please.

I went ahead and saw a doctor today at one of those Physicians Immediate Med places. I took the coughed up piece. He took one look at it and said it's mucus. I kept asking him if he was sure it was mucus and he said yes. I told him several times that to me it looked like lining of my throat. He examined my throat, listened to my lungs. He also did a chest xray which he said looked pretty normal except a mild case of bronchitis. I asked him to send the tissue off for pathology and he said if it would make me feel better, than yes he would send it but he highly suspected it would come back as mucus.

Can a doctor normally tell visually if something is mucus or actual skin tissue? I was surprised he so quickly concluded that it was mucus.
 
 
Answered by Dr. Sumit Bhatti 33 minutes later
Hi,

Thank you for writing back.

1. The pathologist ill be the best judge.

2. If it turns out to be mucus, it has to be a very thick tenacious mucus plug. Looks fleshy in the image. Palpation or the feel of the specimen would have made the doctor suspect it to be thick mucus. However the fact that he agreed to send it for HPE means some doubt exists.

3. It would be better to wait for the HPE report. You may follow up with the report here or at bit.ly/dr-sumit-bhatti

Hope this answers your query. Should you have any additional concerns, I will be glad to assist you further.

Regards.
Above answer was peer-reviewed by
 
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