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Silver JA, Lahijanian Z, Kay-Rivest E, Marquez JC, Young J, Chagnon F, Torres C, Kost KM. Laryngeal Amyloidosis: What is the Role of Imaging? J Voice 2023:S0892-1997(23)00202-3. [PMID: 37596098 DOI: 10.1016/j.jvoice.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 08/20/2023]
Abstract
OBJECTIVE/HYPOTHESIS To review the imaging findings of laryngeal amyloidosis and to identify radiological findings suggestive of this disease. STUDY DESIGN Retrospective case series. METHODS A retrospective chart review of patients with pathologically confirmed laryngeal amyloidosis was performed from 2009 to 2022. Clinical and demographic factors were collected. A fellowship-trained head and neck radiologist reviewed all computed tomography (CT) scans and magnetic resonance imaging (MRI) findings within this cohort. RESULTS 12 patients were identified and a total of 36 imaging studies analyzed. Localized amyloidosis was found in the supraglottic region (n = 6), glottic region (n = 7), and subglottic region (n = 5); six patients had disease spanning two subsites. The most common finding on the CT scan was a homogeneous and well-defined submucosal soft tissue mass. Punctate calcifications were present in three cases. The presence of contrast enhancement was identified in the majority of patients who underwent MRI (4/5). MRI showed consistent signal intensity, hypointense, or isointense on both T1-weighted and T2-weighted images. Diffusion-weighted sequences were obtained in every patient and did not demonstrate diffusion restriction. CONCLUSION This is the largest series searching for unifying imaging characteristics of laryngeal amyloidosis. This research suggests that characteristics from CT and MR provide both similar and unique features of laryngeal amyloidosis on imaging. Both modalities identify a submucosal mass. CT is the preferred modality to demonstrate punctate calcifications, while MRI identifies enhancement and altered signal characteristics. The main benefit of serial imaging is the correlation with patient symptoms, identification of the extent of disease, and assisting in delineating appropriate timing for surgery.
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Affiliation(s)
- Jennifer A Silver
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Zubin Lahijanian
- Department of Radiology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Emily Kay-Rivest
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Juan C Marquez
- Department of Radiology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Jonathan Young
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Francoise Chagnon
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Carlos Torres
- Department of Radiology, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - Karen M Kost
- Department of Otolaryngology-Head and Neck surgery, Royal Victoria Hospital, Montreal, Quebec, Canada.
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Bilateral yellow plaques on the upper eyelids. JAAD Case Rep 2022; 27:134-136. [PMID: 36046809 PMCID: PMC9421086 DOI: 10.1016/j.jdcr.2022.06.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Mira C, Montalvão P, Fonseca I, Borges A. Localised laryngotracheal amyloidosis: a differential diagnosis not to forget. BMJ Case Rep 2021; 14:e237954. [PMID: 33526525 PMCID: PMC7853032 DOI: 10.1136/bcr-2020-237954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/13/2020] [Indexed: 02/03/2023] Open
Abstract
We present a case of multifocal laryngotracheal amyloidosis (LTA) in a 43-year-old man with persistent and progressive dysphonia and dyspnoea, and a first inconclusive histology. Although laryngeal amyloidosis accounts for fewer than 1% of all benign laryngeal tumours, it is in fact the most common site of amyloid deposition in the head, neck and respiratory tract. The clinical scenario is non-specific and diagnosis depends on a high degree of suspicion and on histology. Imaging is useful in mapping lesions, which are often more extensive than they appear during laryngoscopy. Despite being a benign entity, the prognosis is variable with a high-rate and long-latency recurrences, requiring long-term follow-up.
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Affiliation(s)
- Catarina Mira
- Radiology Department, Hospital Beatriz Angelo, Loures, Portugal
| | - Pedro Montalvão
- Otorhinolaryngology Deparment, Portuguese Institute of Oncology of Lisbon, Francisco Gentil, Lisbon, Portugal
| | - Isabel Fonseca
- Pathology, Portuguese Institute of Oncology of Lisbon, Francisco Gentil, Lisboa, Portugal
| | - Alexandra Borges
- Radiology Department, Portuguese Institute of Oncology of Lisbon, Francisco Gentil, Lisboa, Portugal
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Takumi K, Staziaki PV, Hito R, Nadgir RN, Berk JL, Andreu-Arasa VC, Chavez W, Sakai O. Amyloidosis in the head and neck: CT findings with clinicopathological correlation. Eur J Radiol 2020; 128:109034. [PMID: 32438260 DOI: 10.1016/j.ejrad.2020.109034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 03/11/2020] [Accepted: 04/20/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To characterize the CT imaging features of head and neck amyloidosis and correlate with extent of disease and clinical outcomes. MATERIALS AND METHODS This retrospective study included 80 patients with head and neck amyloidosis who underwent soft tissue neck CT imaging between November 2003 and April 2018. The CT imaging features including lesion distribution, morphology (focal, diffuse/circumferential, or combined), presence and pattern of calcification, (punctate or diffuse), and thickness of airway lesion were evaluated and compared with the extent of amyloidosis (localized or systemic), and clinical course (stable, no recurrence, or progression requiring repeated surgical treatment). RESULTS Localized disease (83.8%, 67/80) was most common with AL type (97.6%, 41/42) representing nearly all cases of head and neck amyloidosis. The larynx was the most frequently affected organ (60.0%, 48/80), specifically the glottis (43.8%, 35/80). Calcification was seen in 65.0% of cases (52/80). Non-airway or tongue lesions were significantly associated with systemic (92.3%, 12/13) as opposed to localized amyloidosis (4.5%, 3/67; P < 0.001). Repeated surgical treatment was significantly associated with laryngeal amyloidosis (35.3%, 12/34; P = 0.002) and multi-centric disease (33.3%, 10/30; P = 0.048). Airway wall thickness in patients who required repeated surgical treatment was significantly greater than in patients with stable or no recurrent disease (P = 0.016). CONCLUSION Knowledge of the imaging features of head and neck amyloidosis can aid the diagnosis, disease monitoring, and prediction of patients requiring repeated surgical intervention.
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Affiliation(s)
- Koji Takumi
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States; Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Pedro V Staziaki
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Rania Hito
- Department of Radiology, Veteran Affairs Boston Healthcare System, Boston University School of Medicine, Boston, MA, United States
| | - Rohini N Nadgir
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States; The Russell H. Morgan Department of Radiology and Radiological Science, Division of Neuroradiology, The Johns Hopkins Medical Institutions, Baltimore, MD, United States
| | - John L Berk
- Amyloidosis Center, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - V Carlota Andreu-Arasa
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Wilson Chavez
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States
| | - Osamu Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States; Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, MA, United States.
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Mesolella M, Petruzzi G, Buono S, Salerno G, Salzano FA, Di Lorenzo G, Motta G. Focus on localized laryngeal amyloidosis: management of five cases. Open Med (Wars) 2020; 15:327-332. [PMID: 33335993 PMCID: PMC7712266 DOI: 10.1515/med-2020-0400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/17/2020] [Accepted: 02/23/2020] [Indexed: 11/15/2022] Open
Abstract
Amyloidosis is a group of idiopathic clinical syndromes caused by the deposition of insoluble fibrillar proteins (amyloid) in the extracellular matrix of organs and tissues. These deposits disrupt the function of the target organ. Amyloidosis can manifest as a systemic disease or a single-organ involvement (local form). Its etiology still remains unclear. Deposits of amyloid in the larynx are rare, accounting for between 0.2 and 1.2% of benign tumors of the larynx. In this retrospective study, we report the clinical aspects, diagnosis, treatment and follow-up of five female patients with localized laryngeal amyloidosis without systemic involvement. The patients were all treated successfully using microlaryngoscopy with CO2 laser or cold instruments. Prognosis is excellent; however, appropriate follow-up is an important part of the long-term management of this disease in order to prevent and control the possibility of local recurrence.
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Affiliation(s)
- Massimo Mesolella
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, 80121 Naples, Italy
| | - Gerardo Petruzzi
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, 80121 Naples, Italy
| | - Sarah Buono
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, 80121 Naples, Italy
| | - Grazia Salerno
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, 80121 Naples, Italy
| | - Francesco Antonio Salzano
- Department of Medicine, Surgery and Odontology, “Scuola Medica Salernitana” University of Salerno, Salerno, Italy
| | - Giuseppe Di Lorenzo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, 80121 Naples, Italy
| | - Gaetano Motta
- Department of Mental and Physical Health and Preventive Medicine, Head and Neck Surgery Unit, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Russell LA, Navas de Solis C, Whitfield‐Cargile CM, Deveau MA, Buchanan BR, Gilmour LJ. Imaging findings associated with nasopharyngeal amyloidosis in an Arabian stallion. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.12921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L. A. Russell
- Department of Large Animal Clinical Sciences Texas A&M University College Station USA
| | - C. Navas de Solis
- Department of Large Animal Clinical Sciences Texas A&M University College Station USA
| | | | - M. A. Deveau
- Department of Large Animal Clinical Sciences Texas A&M University College Station USA
| | | | - L. J. Gilmour
- Department of Large Animal Clinical Sciences Texas A&M University College Station USA
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Rudy SF, Jeffery CC, Damrose EJ. Clinical characteristics of laryngeal versus nonlaryngeal amyloidosis. Laryngoscope 2017; 128:670-674. [PMID: 28868800 DOI: 10.1002/lary.26846] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/30/2017] [Accepted: 07/24/2017] [Indexed: 12/28/2022]
Abstract
OBJECTIVES/HYPOTHESIS Amyloidosis represents a heterogeneous group of disorders marked by abnormal protein formation and deposition. Laryngeal amyloidosis is rare and classically thought to remain isolated with little risk of systemic involvement or associated malignancy. This study sought to further characterize differences in clinical characteristics between patients with laryngeal and nonlaryngeal amyloidosis. STUDY DESIGN Retrospective case-control study. METHODS The Stanford Translational Research Integrated Database Environment was searched to identify patients with biopsy-confirmed laryngeal amyloidosis and patients with amyloidosis without laryngeal involvement on endoscopy. Mann-Whitney U and χ2 tests were used for statistical analysis. RESULTS Of 865 patients treated for amyloidosis between 1996 and 2016, 22 (2.5%) patients with biopsy-proven laryngeal amyloidosis were identified. An additional 22 patients with amyloidosis of a different organ and negative laryngoscopy-and therefore without laryngeal amyloidosis-were identified as controls. Compared to these controls with nonlaryngeal amyloidosis, patients with laryngeal amyloidosis were younger (mean age 52.8 years vs. 68.4 years, P < .0006), and 18% had additional organ involvement. Immunoglobulin light-chain amyloidosis was the most common subtype in both groups of patients. Eighty-six percent of patients with laryngeal amyloidosis required surgical excision, and of these patients, over 30% required multiple excisions. CONCLUSIONS There is a significant rate (18%) of multiorgan involvement in patients with laryngeal amyloidosis, which contradicts conventional concepts that this is an isolated disorder. This finding could have a significant impact on the evaluation and management of patients with laryngeal amyloidosis. LEVEL OF EVIDENCE 3b. Laryngoscope, 128:670-674, 2018.
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Affiliation(s)
- Shannon F Rudy
- Department of Otolaryngology-Head and Neck Surgery, Stanford School of Medicine, Stanford University, Stanford, California, U.S.A
| | - Caroline C Jeffery
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - Edward J Damrose
- Department of Otolaryngology-Head and Neck Surgery, Stanford School of Medicine, Stanford University, Stanford, California, U.S.A
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Ginat DT, Schulte J, Portugal L, Cipriani NA. Laryngotracheal Involvement in Systemic Light Chain Amyloidosis. Head Neck Pathol 2017; 12:127-130. [PMID: 28616786 PMCID: PMC5873486 DOI: 10.1007/s12105-017-0831-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 06/10/2017] [Indexed: 12/25/2022]
Abstract
Laryngotracheal amyloid deposition is an uncommon manifestation of systemic light chain amyloidosis. Diagnostic imaging, such as CT, is useful for suggesting the possibility of amyloidosis and delineating the extent of the lesions for surgical management; however, the diagnosis is confirmed with the histologic finding of amorphous eosinophilic material which stains positively for Congo red and may show apple green birefringence on polarization. These features are exemplified in this sine qua non radiology-pathology correlation article.
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Affiliation(s)
- Daniel T. Ginat
- 0000 0004 1936 7822grid.170205.1Department of Radiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637 USA
| | - Jefree Schulte
- 0000 0004 1936 7822grid.170205.1Department of Pathology, University of Chicago, Chicago, IL USA
| | - Louis Portugal
- 0000 0004 1936 7822grid.170205.1Department of Surgery, Section of Otolaryngology, University of Chicago, Chicago, IL USA
| | - Nicole A. Cipriani
- 0000 0004 1936 7822grid.170205.1Department of Pathology, University of Chicago, Chicago, IL USA
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9
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Laryngeal amyloidosis: diagnosis, pathophysiology and management. The Journal of Laryngology & Otology 2017; 131:S41-S47. [DOI: 10.1017/s0022215117000780] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractBackground:Laryngeal amyloidosis represents approximately 1 per cent of all benign laryngeal lesions, and can cause variable symptoms depending on anatomical location and size. Treatment ranges from observation through to endoscopic microsurgery, laser excision and laryngectomy.Objectives:To highlight the diversity of presentations, increase awareness of paediatric amyloidosis and update the reader on current management.Case series:Five cases are illustrated. Four adult patients were female, and the one child, the second youngest in the literature, was male. Amyloid deposits were identified in all laryngeal areas, including the supraglottis, glottis and subglottis. Treatment consisted of balloon dilatation, endoscopic excision, laser cruciate incision, and resection with carbon dioxide laser, a microdebrider and coblation wands.Conclusion:Laryngeal amyloidosis remains a rare and clinically challenging condition. Diagnosis should be considered for unusual appearing submucosal laryngeal lesions. Treatment of this disease needs to be evaluated on a case-by-case basis and managed within an appropriate multidisciplinary team.
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Intensity-modulated radiotherapy for localized nasopharyngeal amyloidosis. Strahlenther Onkol 2016; 192:944-950. [DOI: 10.1007/s00066-016-0996-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
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Shroff GS, Ocazionez D, Vargas D, Carter BW, Wu CC, Nachiappan AC, Gupta P, Restrepo CS. Pathology of the Trachea and Central Bronchi. Semin Ultrasound CT MR 2016; 37:177-89. [DOI: 10.1053/j.sult.2015.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Long-term follow-up after surgery in localized laryngeal amyloidosis. Eur Arch Otorhinolaryngol 2016; 273:2613-20. [PMID: 27156084 PMCID: PMC4974288 DOI: 10.1007/s00405-016-4061-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 04/19/2016] [Indexed: 10/26/2022]
Abstract
To study effectiveness of surgery and watchful waiting in localized laryngeal amyloidosis, retrospective case series. This retrospective study comprises all consecutive patients with localized laryngeal amyloidosis surgically treated in a tertiary hospital between 1994 and February 2016. Recurrence rate, revision surgery, progression to systemic amyloidosis, and changes in voice were monitored yearly. Eighteen patients were included. Seven women and eleven men had a median age 50 years (range 21-77 years) and median follow-up 6.4 years (2.4-17 years). Amyloid was located in subglottis (5), glottis (8), false vocal folds (8) and other supraglottic areas (5), in more than one laryngeal region (13) and bilaterally (12). Cold steel excision was used at the glottis; CO2 laser excision, sometimes assisted by microdebrider, at other laryngeal areas. Eleven patients needed revision surgery, ten within the first 4 years after surgical treatment. One patient needed his first revision surgery after 11 years. Five patients needed a second revision within 6 years after initial diagnosis. Two patients needed a third revision. Indications for first revision surgery were progression (8) with dysphonia (7), dyspnea (2), dysphagia (1), exclusion of malignancy (1), and aphonia (1). No patient developed systemic amyloidosis during follow-up. Although local progression of amyloid necessitates revision surgery once or twice in the first 4-6 years, progression slows down thereafter. Late progression, however, remains possible.
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Narechania S, Valent J, Farver C, Tonelli AR. A 70-Year-Old Man With Large Cervical and Mediastinal Lymphadenopathies. Chest 2015; 148:e8-e13. [PMID: 26149568 DOI: 10.1378/chest.14-3124] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
We present a case of a 70-year-old man with enlarged mediastinal and cervical lymph nodes that provided interesting radiologic and pathologic observations. The 70-year-old black man was found to have enlarged mediastinal lymph nodes. He had symptoms of atypical chest pain and generalized weakness for 2 weeks prior to the diagnosis. He denied shortness of breath, fever, chills, or night sweats. He was treated for hypertension and onychomycosis. Basic laboratory findings were within normal limits. Pulmonary function tests at the time of presentation showed FEV1, FVC, and FEV1/FVC ratio of 123% predicted, 133% predicted, and 0.7, respectively. Meanwhile, total lung capacity and carbon monoxide diffusing capacity were 103% and 107% predicted, respectively. Two weeks before he presented to our institution, the patient underwent bronchoscopy with transbronchial biopsies of the right lower lobe and endobronchial ultrasound-guided transbronchial needle aspiration of the right hilar lymph nodes.
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Affiliation(s)
| | - Jason Valent
- Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH
| | - Carol Farver
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH
| | - Adriano R Tonelli
- Department of Pulmonary, Allergy and Critical Care Medicine, Cleveland Clinic, Cleveland, OH; Respiratory Institute, Cleveland Clinic, Cleveland, OH.
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Tao TY, Menias CO, Herman TE, McAlister WH, Balfe DM. Easier to Swallow: Pictorial Review of Structural Findings of the Pharynx at Barium Pharyngography. Radiographics 2013; 33:e189-208. [DOI: 10.1148/rg.337125153] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Szkiełkowska A, Slusarczyk A, Pietrasik K, Skarżyński H. [Tornwald's cyst in clinical practice]. Otolaryngol Pol 2013; 67:170-5. [PMID: 23719275 DOI: 10.1016/j.otpol.2013.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 03/07/2013] [Indexed: 10/27/2022]
Abstract
AIM Tornwald's cyst is a recess in the midline of the nasopharynx, which is produced by persistent notochord remnants. The aim of the study was to present difficulties in diagnostic procedures in patients with Tornwald's cyst suspicion. MATERIAL AND METHOD Authors present 2 cases of patients being treated for Tornwald's cyst in the Audiology and Phoniatrics Clinic of Institute of Physiology and Pathology of Hearing in Warsaw. RESULTS Discussed patients complained fullness in ears, hearing disorders, tinnitus, dysphagia, occipital headaches and balance problem. Both patients underwent ENT examination with endoscopic examination of nasopharynx and hearing assessment tests(pure tone audiometry, impedance audiometry). Magnetic resonance imaging and computer tomography were also performed. Surgery of nasopharyngeal cyst and tympanotomy with drainage of middle ear were performed in one patient. Second patient was treated with TRT therapy for her tinnitus. CONCLUSION Tornwald's cyst should be remembered as an uncommon cause of hearing problems, tinnitus, fullness in ears, dysphagia, occipital headaches and balance problem. Magnetic resonance imaging seems to be the most specific method in Tornwald's cyst diagnosis.
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Affiliation(s)
- Agata Szkiełkowska
- Klinika Audiologii i Foniatrii Instytutu Fizjologii i Patologii Słuchu, Warsaw, Poland.
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Hemorragia intracerebral recurrente en amiloidosis primaria. Neurologia 2013; 28:252-5. [DOI: 10.1016/j.nrl.2011.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2011] [Revised: 07/27/2011] [Accepted: 10/09/2011] [Indexed: 11/19/2022] Open
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Rojo Martínez E, Guerrero Peral A, Herrero Velázquez S, Núñez García J. Recurrent intracereberal haemorrhage in primary amyloidosis. NEUROLOGÍA (ENGLISH EDITION) 2013. [DOI: 10.1016/j.nrleng.2011.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Feeney DA, Sharkey LC, Steward SM, Bahr KL, Henson MS, Ito D, O'Brien TD, Jessen CR, Husbands BD, Borgatti A, Modiano JF. Parenchymal signal intensity in 3-T body MRI of dogs with hematopoietic neoplasia. Comp Med 2013; 63:174-182. [PMID: 23582424 PMCID: PMC3625058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/16/2012] [Accepted: 11/15/2012] [Indexed: 06/02/2023]
Abstract
We performed a preliminary study involving 10 dogs to assess the applicability of body MRI for staging of canine diffuse hematopoietic neoplasia. T1-weighted (before and after intravenous gadolinium), T2-weighted, in-phase, out-of-phase, and short tau inversion recovery pulse sequences were used. By using digital region of interest (ROI) and visual comparison techniques, relative parenchymal organ (medial iliac lymph nodes, liver, spleen, kidney cortex, and kidney medulla) signal intensity was quantified as less than, equal to, or greater than that of skeletal muscle in 2 clinically normal young adult dogs and 10 dogs affected with either B-cell lymphoma (n = 7) or myelodysplastic syndrome (n = 3). Falciform fat and urinary bladder were evaluated to provide additional perspective regarding signal intensity from the pulse sequences. Dogs with nonfocal disease could be distinguished from normal dogs according to both the visual and ROI signal-intensity relationships. In normal dogs, liver signal intensity on the T2-weighted sequence was greater than that of skeletal muscle by using either the visual or ROI approach. However in affected dogs, T2-weighted liver signal intensity was less than that of skeletal muscle by using either the ROI approach (10 of 10 dogs) or the visual approach (9 of 10 dogs). These findings suggest that the comparison of relative signal intensity among organs may have merit as a research model for infiltrative parenchymal disease (ROI approach) or metabolic effects of disease; this comparison may have practical clinical applicability (visual comparison approach) as well.
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Affiliation(s)
- Daniel A Feeney
- Department of Veterinary Clinical Sciences, University of Minnesota, St Paul, Minnesota, USA.
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Multidetector-row Computed Tomography of Diffuse Tracheal Disease: Pictorial Review. J Bronchology Interv Pulmonol 2012; 16:28-36. [PMID: 23168465 DOI: 10.1097/lbr.0b013e318195e1e4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Diffuse tracheal diseases are uncommon and may mimic asthma or other forms of chronic obstructive lung disease. Bronchoscopy is usually definitive in establishing a diagnosis and assessing the severity of diffuse tracheal disease. However, advances in multidetector-row computed tomography (MDCT) technology allow for rapid acquisition time and generation of high-quality multiplanar reconstructions and virtual bronchoscopic images, making MDCT evaluation of suspected or known tracheal disease the noninvasive examination of choice. The MDCT findings of the various diseases that diffusely affect the trachea may be highly suggestive of 1 particular disease or narrow the differential diagnosis to a few possibilities. Moreover, MDCT imaging of the chest can help identify associated lung disease or complications of diffuse tracheal disease such as pneumonia or atelectasis. This pictorial review illustrates the MDCT appearances of the more common diffuse tracheal diseases.
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Tonsil amyloidosis revealing a Waldenström macroglobulinemia. Eur Arch Otorhinolaryngol 2011; 269:1301-4. [PMID: 22197994 DOI: 10.1007/s00405-011-1886-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 12/12/2011] [Indexed: 12/19/2022]
Abstract
Localized amyloidosis of the tonsil is rare and its management depends on the etiology. We report a case of tonsil amyloidosis and review the characteristics of this exceptional pathology. A 74-year-old man consulted for odynophagia, upper dysphagia and deteriorated general health status, which have been evolving for 1 year. Clinical examination found a smooth swelling of the right palatine tonsil. No further abnormalities were noted. The biopsy findings were consistent with amyloidosis. Etiological assessment pointed to Waldenstrom macroglobulinemia. Tonsillectomy was performed. The patient was managed by chemotherapy associating chlorambucil, vincristine and prednisone. The progress after chemotherapy was good. Localized amyloidosis is a rare lesion of the superior aerodigestive tract, predominating in the larynx and tonsil involvement is exceptional. Its diagnosis is histological and its management depends on the etiology. Continued regular follow-up is necessary to look for recurrence.
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Dufour X. Pathologie pharyngolaryngée et médecine interne. Rev Med Interne 2011; 32 Suppl 1:S9-11. [DOI: 10.1016/j.revmed.2011.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Yakoot A, Giusiano S, Sanjuan M, Mardassi A, Magnan J, Devèze A. An unusual cause of serous otitis media. Eur Ann Otorhinolaryngol Head Neck Dis 2011; 127:156-8. [PMID: 20860926 DOI: 10.1016/j.anorl.2010.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2010] [Revised: 06/21/2010] [Accepted: 07/11/2010] [Indexed: 12/01/2022]
Affiliation(s)
- A Yakoot
- CHU Nord, Hôpitaux de Marseille, université de La Méditerranée, France
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Hammami B, Mnejja M, Kallel S, Bouguecha L, Chakroun A, Charfeddine I, Ghorbel A. Hypopharyngeal amyloidosis: A case report. Eur Ann Otorhinolaryngol Head Neck Dis 2010; 127:83-5. [PMID: 20822762 DOI: 10.1016/j.anorl.2010.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Accepted: 01/19/2010] [Indexed: 11/16/2022]
Abstract
Hypopharyngeal amyloidosis is rare. Management depends on etiology. We report a case of hypopharyngeal amyloidosis and review the characteristics of this exceptional pathology. A 60-year-old woman with a history of diabetes and chronic cervicalgia consulted for dysphagia and deteriorated general health status, which had been evolving for 2 months. Clinical examination found two ulcerations of the lateral edge of the tongue and right pyriform sinus salivary stasis. Panendoscopy found regular swelling of the posterior wall of the hypopharynx and cervical esophagus. The pyriform sinuses and larynx were normal. Cervical CT and MRI showed thickening of the posterior wall of the hypopharynx. Biopsy found amorphous acellular eosinophil interstitial deposits, shown to be amyloid on Congo red staining, leading to a diagnosis of amyloidosis. Etiological assessment pointed to myeloma. The patient was managed by chemotherapy associating melphalan and prednisone. Evolution at 12 months' follow-up was good. Localized amyloidosis is a rare lesion of the superior aerodigestive tract, predominating in the larynx. Hypopharyngeal involvement is exceptional. Diagnosis is histological. Management depends on etiology. Local treatment is exceptional other than in case of complication. Systemic forms with associated myeloma are of poor prognosis.
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Affiliation(s)
- B Hammami
- ENT and Head and Neck Surgery Department, Habib Bourguiba Teaching Hospital, Sfax 3029, Tunisia.
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Abstract
Tracheobronchial imaging has undergone a major revolution since the advent of MDCT. The improved spatial and temporal resolution not only allows reformatting images that enhance the comprehension of disease before bronchoscopy or surgery, it has introduced newer techniques such as dynamic expiratory imaging to evaluate for tracheomalacia, which can be a subtle, but a confounding entity for patients and clinician alike. Tracheobronchial diseases can be arbitrarily divided into those that cause focal and diffuse narrowing and widening. Such groupings can help develop a practical approach in evaluating diseases of the central airways.
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Affiliation(s)
- Cylen Javidan-Nejad
- Section of Cardiothoracic Imaging, Department of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, Box 8131, St. Louis, MO 63110, USA.
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Abstract
Tracheobronchial imaging has undergone a major revolution. The improved spatial and temporal resolution has introduced newer techniques such as dynamic expiratory imaging to evaluate for tracheomalacia. This article describes these techniques.
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Affiliation(s)
- Cylen Javidan-Nejad
- Section of Cardiothoracic Imaging, Department of Radiology, Washington University School of Medicine, St Louis, MO 63110, USA.
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Seccia V, Dallan I, Cervetti G, Lenzi R, Marchetti M, Casani AP, Muscatello L. A rare case of primary systemic amyloidosis of the neck with massive cervical lymph node involvement: a case report and review of the literature. Leuk Res 2009; 34:e100-3. [PMID: 19931179 DOI: 10.1016/j.leukres.2009.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Revised: 10/17/2009] [Accepted: 10/20/2009] [Indexed: 10/20/2022]
Abstract
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, neck lymph node involvement is rare, with only five previous cases reported. We present the case of a primary systemic AL amyloidosis with hepatic, cervical, retroperitoneal, axillary and inguinal lymphnode localizations, unresponsive to medical therapy and treated with a surgical approach followed by autologous bone marrow transplantation. We review the pertinent literature with exclusive attention to the otorhinolaryngologic aspect.
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Yiotakis I, Georgolios A, Charalabopoulos A, Hatzipantelis P, Golias C, Charalabopoulos K, Manolopoulos L. Primary localized laryngeal amyloidosis presenting with hoarseness and dysphagia: a case report. J Med Case Rep 2009; 3:9049. [PMID: 19918287 PMCID: PMC2767149 DOI: 10.4076/1752-1947-3-9049] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 01/23/2009] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Primary localized laryngeal amyloidosis is an extremely rare condition. It usually presents with hoarseness, pain and/or difficulty in breathing. CASE PRESENTATION We present the case of a 23-year-old woman with primary localized laryngeal amyloidosis who presented with hoarseness and dysphagia. CONCLUSION A search of PubMed shows that dysphagia in patients with laryngeal amyloidosis has been reported only once, although this symptom is relatively common in other conditions presenting with laryngeal mass. There were no signs of any systemic disease in our patient and diagnosis was established histopathologically. She was treated surgically by microlaryngoscopy under general anesthesia and the mass was excised using a CO(2) laser technology method.
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Razek AAKA, Castillo M. Imaging appearance of granulomatous lesions of head and neck. Eur J Radiol 2009; 76:52-60. [PMID: 19501997 DOI: 10.1016/j.ejrad.2009.05.021] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 05/12/2009] [Accepted: 05/13/2009] [Indexed: 11/29/2022]
Abstract
We aim to review the imaging appearance of granulomatous lesions of the head and neck. Granulomatous lesions are seen in different regions of the head and neck and a difficult diagnostic challenge for the radiologist. Infective granulomas may be due to bacterial or fungal agents. Non-infective granulomas are Wegener's granulomatosis, sarcoidosis, amyloidosis, chemical granuloma and reparative giant cell granuloma. Familiarity with the clinical presentation and imaging features of these lesions can suggest diagnosis in some cases. CT and MR imaging demonstrate the exact location, extension and effect on surrounding structures. A thorough knowledge of age, gender, common location, clinical features and imaging appearance of granulomatous lesions are important for diagnosis.
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