Management of Amyloidosis of the Larynx and Trachea

Amyloidosis of the Larynx: A Clinicopathologic Study of 11 Cases

“…The second theory for the amyloid deposition suggests that a circulating precursor protein is deposited in the stroma after a change in the vascular permeability as a result of local inflammation (2,9,25,26,30). The plasma cells may be either inciting the inflammation or reacting to the amyloid.…”

“…The plasma cells may be either inciting the inflammation or reacting to the amyloid. There are an insufficient number of cases to implicate chronic inflammation and/or an infectious agent as the cause of organ-specific amyloidosis (1,9,25,30). In an individual case, the possibility of a circu- lating immunoglobulin protein or a variable portion of a light chain as the source of the amyloid fibrils of immunoglobulin origin must still be considered, even though it seems more likely that it is formed from the contiguous plasmacytic infiltrate (26).…”

“…Furthermore, as indicated clinically, a rectal, lip, gum, kidney, spleen, liver, endomyocardial, skin, or small-bowel biopsy and/or abdominal fat aspirate may be performed to exclude systemic disease. An endoscopic examination of the aerodigestive tract may be necessary, given the high incidence of multifocal involvement by the disease (1,3,8,9,17,19,25,27). As noted, none of our patients demonstrated evidence of lymphadenopathy, multiple myeloma, or an overt B-cell neoplasm.…”

KTP Laser in Laryngeal Amyloidosis: Five Cases with Review of Literature

“…Most common area of laryngeal involvement is vestibule, followed by the false cords, the aryepiglottic folds and subglottic region [12,13]. However, Finn and Farmer found the true vocal cord to be the most common site [14].…”

Primary Laryngeal Amyloidosis

“…3) Laser evaporation: CO 2 laser has been used with varying degrees of success. 17,18 This is the treatment of choice for small, recurring masses, being the least traumatizing procedure. Laryngeal function is mostly preserved, but the treatment is not available in all centers; time-consuming and special precautions are needed to prevent complications and hazards for patients and theater personnel.…”