Localized Amyloid Deposition in the Nasopharynx and Neck, Mimicking Nasopharyngeal Carcinoma with Neck Metastasis

Zhuang, Yu-Long; Tsai, Tung-Lung; Lin, Ching‐Yi

doi:10.1016/s1726-4901(09)70236-9

Cited by 22 publications

(14 citation statements)

References 9 publications

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“…Amy lo i do sis very ra rely in vol ves the na sop harynx or the neck. 7 The cli ni cal ma ni fes ta ti ons of amy lo i do sis are va ri o us and de pend on the bi oc he mi cal na tu re of the fib ril pro te in and are a in vol ve ment. In systemic amy lo i do sis, pro te i nu ri a is of ten the first symptom; ot her ma ni fes ta ti ons inc lu de pe rip he ral ne u ro pat hi es, de men ti a and cog ni ti ve dysfunc ti on, and or gan en lar ge ment, es pe ci ally of the li ver, kidney, sple en and he art.…”

Section: Discussionmentioning

confidence: 99%

“…6 Spe ci fic or gan in vol ve ment may al so be exc lu ded by la bora tory or ra di o lo gi cal stu di es. 7 Un li ke syste mic amy lo i do sis, lo ca li zed amylo i do sis has an ex cel lent prog no sis. Sur gery is repor ted to be the best the rapy for lo ca li zed amy lo i do sis.…”

Section: Discussionunclassified

“…To da te, there has only be en one si mi lar ca se re port in the li te ra tu re. 7 This ra re ca se was dis cus sed with a revi ew of the li te ra tu re…”

mentioning

confidence: 99%

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Localized Amyloidosis in the Nasopharynx and Neck: Case Report

Özdemir¹,

Öztürkcan²,

Güvenç³

et al. 2010

Turkiye Klinikleri J Med Sci

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Section: Discussionmentioning

confidence: 99%

Section: Discussionunclassified

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Localized Amyloidosis in the Nasopharynx and Neck: Case Report

Özdemir¹,

Öztürkcan²,

Güvenç³

et al. 2010

Turkiye Klinikleri J Med Sci

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“…However, the most common head and neck sites are the supraglottic and subglottic larynx as well as the thyroid gland. 4,6,7 There were 12 previous cases that date back to 1980. 8 Of these 12 cases, 10 were of localized disease of the nasopharynx.…”

Section: Discussionmentioning

confidence: 99%

Severe Diffuse Systemic Amyloidosis with Involvement of the Pharynx, Larynx, and Trachea: CT and MR Findings

Gilad¹,

Milillo²,

Som³

2007

American Journal of Neuroradiology

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SUMMARY:Amyloidosis is a term applied to a diverse group of disorders that share the deposition of amyloid protein in various extracellular tissues. Systemic amyloidosis may involve almost any organ system in the body including regions in the head and neck; however, pharyngeal involvement is rare, with only 12 cases having been previously reported. Ten of these cases were localized disease, and only 2 cases were systemic amyloidosis. We present the case of a patient with severe diffuse systemic amyloidosis with extensive involvement of the pharynx, larynx, trachea, lungs, eyelids, and breasts. We also review the imaging characteristics and pertinent literature.A myloidosis is a rare, infiltrative condition characterized by deposition of abnormal protein in various tissues. When systemic amyloidosis involves regions of the head and neck, the larynx and trachea are the most common sites. To date, there have been only 2 prior reported cases of systemic amyloidosis involving the pharynx. We present a case of severe diffuse systemic amyloidosis in the chest, head and neck, with extensive involvement of the pharynx and we review the literature. Case ReportThe patient was a 64-year-old woman with a history of myasthenia gravis for 30 years, type 1 diabetes mellitus, and amyloidosis for 4 years. In the past, the patient was found to have amyloid deposits in the eyelids and breasts. A biopsy confirmed findings consistent with the AL type (amyloid light chain) of amyloidosis. The patient presented with increased shortness of breath and hoarseness on the most recent hospital admission. There was no past medical history of renal failure or multiple myeloma. The patient was being treated for myasthenia gravis with pyridostigmine (Mestinon) and high-dose steroids and had received plasmapheresis therapy in the past. Physical examination was significant for bilateral ptoses and indurations of the eyelids, pharyngeal fullness, shortness of breath, and a decreased range of motion of the neck. Her urine was negative for Bence-Jones protein, and the results of serum protein and urine protein electrophoreses were unremarkable.A tracheostomy was performed, and a high-resolution chest CT study showed extensive interstitial lung disease, abnormally attenuated breast tissue (Fig 1) for the patient's stated age, and small nodules in the tracheal mucosa with marked thickening of the tracheal wall with significant stenosis (not shown). An endoscopic examination of the trachea revealed nodular deposits and plaques on the mucosal surface along its entire length. Noncontrast MR imaging of the neck was performed on a 1.5T magnet. Contrast was not administered because of a reported allergy to gadolinium. The images showed large submucosal, nodular masses in the pharynx and supraglottic larynx, and thickening of the tracheal wall with stenosis. These masses had intermediate T1-weighted signal intensity (Figs 2A) and low T2-weighted signal intensity ( Figs 2B, C, D). The large submucosal supraglottic laryngeal deposits were the primary cause of h...

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“…Facial pain can be seen in amyloidosis of the maxillary antrum (MCALPINE JC, 1964). Occasionally, it may manifest as a clinical picture simulating an apparent malignancy with cervical nodal metastasis (Zhuang YL, 2005). Generally, the appearance is described as a yellowish or whitish polypoid, firm mass.…”

Section: Sino-nasal and Nasopharyngeal Amyloidosismentioning

confidence: 99%