Pharyngolaryngeal sarcoidosis: Report of 12 cases

Abstract

P haryngolaryngeal sarcoidosis (PLS) can be integrated in a multisystemic sarcoidosis or more exceptionally can be isolated. Course, natural history, and long-term prognosis are poorly understood. 1,2 18 F-Fluorodeoxyglucose positron emission tomography coupled with CT (18F-FDG PET/CT) is a noninvasive imaging tool with a potential role in management of thoracic and extrathoracic sarcoidosis. Nevertheless, the usefulness of 18F-FDG PET/CT has not been completely evaluated for PLS. [3][4][5] METHODS AND MATERIALSTwelve consecutive patients with biopsy-proven PLS were retrospectively included in this study. Assessment for inclusion involved: 1) complete clinical and endoscopic evaluation, 2) measurement of serum angiotensin-converting enzyme (SACE), 3) high-resolution sinonasal, neck, and thoracic CT, 4) PET/CT in six patients, and 5) 46 biopsies of macroscopically visible lesions (Table 1). The treatment involved oral corticosteroid therapy in 11 cases, associated with immunosuppressive drugs in four of these cases. The corticosteroids (0.5-1 mg/kg daily of prednisolone) in tapering doses were maintained for months or years according to the evolution of PLS and other associated sarcoidosis localizations. Four patients also underwent surgical procedure: microsurgery of the vocal cords in three cases and recalibration of the larynx in one case. The average follow-up was 5 years and included clinical and endoscopic investigations, CT, SACE measurement, and PET/CT after treatment in four cases. The study was approved by the

Endoscopic Airway Management of Laryngeal Sarcoidosis

“…The results of our study demonstrate that our case mix of laryngeal sarcoid is not dissimilar to that of other studies. 3,5,12,21 Clinically, patients presented with predominant symptoms of dyspnea and dysphonia. However, it was the unit's experience that the high degree of dyspnea prompted the patient's preference for surgical treatment.…”

Atypical and uncommon presentation of sarcoidosis with long segment involvement of the pharynx and larynx: Case report and review of literature

“…Localized masses, cervical lymphadenopathy and obliteration of pyriform sinuses occasionally appear on CT [21] . CT scan is inconclusive for isolated PLS diagnosis [22] . 18 F-Fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) shows increased uptake of 18F-FDG by the granulomatous lesions.…”

“…18 F-Fluorodeoxyglucose positron emission tomography with computed tomography (18F-FDG PET/CT) shows increased uptake of 18F-FDG by the granulomatous lesions. It has a diagnostic sensitivity of 85% in localization for PLS lesions [22] . Because these PET/CT results are concerning for malignancy and they are nonspecific for sarcoidosis, a biopsy is mandated to exclude malignancy and confirm the diagnosis [22] .…”

“…It has a diagnostic sensitivity of 85% in localization for PLS lesions [22] . Because these PET/CT results are concerning for malignancy and they are nonspecific for sarcoidosis, a biopsy is mandated to exclude malignancy and confirm the diagnosis [22] . MRI shows submucosal thickening with hypointensity on T2-wighted images that enhance after gadolinium [23] .…”