Laryngeal Amyloidosis in a Child

Abstract

A 14-year-old girl developed progressive hoarseness and breathing difficulty due to a mass in the subglottic larynx. A biopsy specimen obtained at direct laryngoscopy snowed localized aggregates of amyloid. The lesion was excised completely with a carbon dioxide laser. This is the second case of laryngeal amyloidosis in a child reported in the English-language literature.

Amyloidosis of the Upper Aerodigestive Tract

“…Amyloidosis of the upper digestive tract cannot be diagnosed by visual inspection alone, because the clinical appearance of amyloid mimics the clinical appearance of other lesions. For example, on laryngoscopy, amyloid appears as a yellow, gray, or red subepithelial mass 6 and may be mistaken for a benign vocal fold polyp or laryngocele. 26 Computed tomography or magnetic resonance imaging may be helpful in mapping lesions, which may often be more extensive than they appear during laryngoscopy.…”

“…Methyl violet and thioflavine‐T stain may also be used to diagnose amyloidosis, revealing a metachromatic pink‐violet in the presence of amyloid fibrils. 6,8,26 Staining for the SAP is an excellent adjunct for ensuring an accurate diagnosis. 9 Without proper staining, pseudoamyloid, found in laryngeal polyps and degenerated hyaline cartilage, may be mistaken for amyloid.…”

“…It rarely presents during childhood, with only a few documented cases. 4,6 Male subjects predominate by a ratio of approximately 3 to 1. 7,8 Laryngeal amyloidosis is usually a localized phenomenon that is rarely associated with systemic involvement.…”

Primary Amyloidosis of Larynx – A Case Report

“…Congo red staining demonstrates the classic appearance of bright green birefringence under polarizing light microscope. Methyl violet and thioflavine-T stain may also be used to diagnose amyloidosis, revealing a metachromatic pinkviolet in the presence of amyloid fibrils 7,10 .…”

Nasopharyngeal, Laryngeal and Tracheal Amyloidosis

“…En sık tutulumun olduğu organlar larenks ve akciğerlerdir. 6 Lokalize amiloidozun baş-boyun bölgesinde en sık tulum yaptığı yer larenkstir. 7 Baş-boyun bölgesinde larenksten sonra tiroid ve parotis bezi, paranazal sinüsler ve oral kavite gibi birçok alanda tutulum bildirilmiştir.…”