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Laryngeal amyloidosis: diagnosis, pathophysiology and management

Published online by Cambridge University Press:  30 May 2017

N M Phillips ,
E Matthews ,
C Altmann ,
J Agnew  and
H Burns
N M Phillips*
Affiliation:
ENT Department, Rockhampton Hospital, Queensland, Australia School of Medicine, University of Queensland, St Lucia, Queensland, Australia
E Matthews
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Mater Private Hospital, Rockhampton, Queensland, Australia
C Altmann
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Mater Medical Centre, Townsville, Queensland, Australia
J Agnew
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
H Burns
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Lady Cilento Children's Hospital, South Brisbane, Queensland, Australia
*
Address for correspondence: Dr Nicholas M Phillips, PO Box 1676, Noosa Heads, QLD, Australia Fax: +61 (07) 5455 3566 E-mail: nicholas.phillips@uqconnect.edu.au
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Abstract

Background:

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.

Keywords

Laryngeal AmyloidosisAmyloidosisLarynx
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Supplement S2: ASOHNS Supplement , July 2017 , pp. S41 - S47
Copyright
Copyright © JLO (1984) Limited 2017 

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References

1 Sipe, JD, Benson, MD, Buxbaum, JN, Ikeda, SI, Merlini, G, Saraiva, MJ et al. Nomenclature 2014: amyloid fibril proteins and clinical classification of the amyloidosis. Amyloid 2014;21:221–4CrossRefGoogle ScholarPubMed
2 Gertz, MA. Immunoglobulin light chain amyloidosis: 2013 update on diagnosis, prognosis, and treatment. Am J Hematol 2013;88:416–25CrossRefGoogle ScholarPubMed
3 Merlini, G, Westermark, P. The systemic amyloidoses: clearer understanding of the molecular mechanisms offers hope for more effective therapies. J Intern Med 2004;255:159–78CrossRefGoogle ScholarPubMed
4 Passerotti, GH, Caniello, M, Hachiya, A, Santoro, PP, Imamura, R, Tsuji, DH. Multiple-sited amyloidosis in the upper aerodigestive tract: case report and literature review. Braz J Otorhinolaryngol 2008;74:462–6Google Scholar
5 Thompson, LD, Derringer, GA, Wenig, BM. Amyloidosis of the larynx: a clinicopathologic study of 11 cases. Mod Path 2000;13:528–35Google Scholar
6 Lebowitz, RA, Morris, L. Plasma cell dyscrasias and amyloidosis. Otolaryngol Clin North Am 2003;36:747–64CrossRefGoogle ScholarPubMed
7 Pribitkin, E, Friedman, O, O'Hara, B, Cunnane, MF, Levi, D, Rosen, M et al. Amyloidosis of the upper aerodigestive tract. Laryngoscope 2003;113:2095–101Google Scholar
8 Balbani, AP, Formigoni, GG, Sennes, LU, Jacob, F, Miniti, A, de Carvalho, TS. Primary laryngeal amyloidosis in a child. J Otolaryngol 1999;28:171–2Google Scholar
9 Godbersen, GS, Leh, JF, Hansmann, ML, Rudert, H, Linke, RP. Organ-limited laryngeal amyloid deposits: clinical, morphological, and immunohistochemical results of five cases. Ann Otol Rhinol Laryngol 1992;101:770–5Google Scholar
10 Nagasaka, T, Lai, R, Kuno, K, Nakashima, T, Nakashima, N. Localized amyloidosis and extramedullary plasmacytoma involving the larynx of a child. Hum Pathol 2001;32:132–4CrossRefGoogle ScholarPubMed
11 Hurbis, CG, Holinger, LD. Laryngeal amyloidosis in a child. Ann Otol Rhinol Laryngol 1990;99:105–7Google Scholar
12 Mitrani, M, Biller, HF. Laryngeal amyloidosis. Laryngoscope 1985;95:1346–7Google Scholar
13 O'Halloran, LR, Lusk, RP. Amyloidosis of the larynx in a child. Ann Otol Rhinol Laryngol 1994;103:590–4Google Scholar
14 Clevens, RA, Wiatrak, BJ, Myers, MW. Multifocal amyloidosis of the pediatric airway. Arch Otolaryngol Head Neck Surg 1995;121:229–32CrossRefGoogle ScholarPubMed
15 Wierzbicka, M, Budzyński, D, Piwowarczyk, K, Bartochowska, A, Marszałek, A, Szyfter, W. How to deal with laryngeal amyloidosis? Experience based on 16 cases. Amyloid 2012;19:177–81Google Scholar
16 Simpson, GT 2nd, Skinner, M, Strong, MS, Cohen, AS. Localized amyloidosis of the head and neck and upper aerodigestive and lower respiratory tracts. Ann Otol Rhinol Laryngol 1984;93:374–9Google Scholar
17 Barnes, EL, Zafar, T. Laryngeal amyloidosis: clinicopathologic study of seven cases. Ann Otol Rhinol Laryngol 1977;86:856–63Google Scholar
18 Lewis, JE, Olsen, KD, Kurtin, PJ, Kyle, RA. Laryngeal amyloidosis: a clinicopathologic and immunohistochemical review. Otolaryngol Head Neck Surg 1992;106:372–7CrossRefGoogle ScholarPubMed
19 Piazza, C, Cavaliere, S, Foccoli, P, Toninelli, C, Bolzoni, A, Peretti, G. Endoscopic management of laryngo-tracheobronchial amyloidosis: a series of 32 patients. Eur Arch Otorhinolaryngol 2003;260:349–54CrossRefGoogle ScholarPubMed
20 Aydin, Ö, Üstündaǧ, E, İşeri, M, Özkarakaş, H, Oǧuz, A. Laryngeal amyloidosis with laryngocele. J Laryngol Otol 1999;113:361–3Google Scholar
21 Bartels, H, Dikkers, FG, van der Wal, JE, Lokhorst, HM, Hazenberg, BP. Laryngeal amyloidosis: localized versus systemic disease and update on diagnosis and therapy. Ann Otol Rhinol Laryngol 2004;113:741–8Google Scholar
22 Sachchithanantham, S, Wechalekar, AD. Imaging in systemic amyloidosis. Br Med Bull 2013;107:41–56 Google Scholar
23 Hazenberg, BP, van Rijswijk, MH, Piers, DA, Lub-de Hooge, MN, Vellenga, E, Haagsma, EB et al. Diagnostic performance of 123I-labeled serum amyloid P component scintigraphy in patients with amyloidosis. Am J Med 2006;119:15–24 Google Scholar
24 Hawkins, PN, Richardson, S, Vigushin, DM. Serum amyloid P component scintigraphy and turnover studies for diagnosis and quantitative monitoring of AA amyloidosis in juvenile rheumatoid arthritis. Arthritis Rheum 1993;36:842–51Google Scholar
25 Rosengren, S, Mellqvist, UH, Nahi, H, Forsberg, K, Lenhoff, S, Strömberg, O et al. Outcome of AL amyloidosis after high-dose melphalan and autologous stem cell transplantation in Sweden, long-term results from all patients treated in 1994–2009. Bone Marrow Transplant 2016;51:1569–72Google Scholar
26 Celenk, F, Durucu, C, Baysal, E, Karatas, ZA, Polat, M, Bakir, K et al. Management of upper aerodigestive tract amyloidosis. Ann Otol Rhinol Laryngol 2013;122:535–40Google Scholar
27 Deviprasad, D, Pujary, K, Balakrishnan, R, Nayak, DR. KTP laser in laryngeal amyloidosis: five cases with review of literature. Indian J Otolaryngol Head Neck Surg 2013;65:36–41 Google Scholar
28 Paccalin, M, Hachulla, E, Cazalet, C, Tricot, L, Carreiro, M, Rubi, M et al. Localized amyloidosis: a survey of 35 French cases. Amyloid 2009;12:239–45CrossRefGoogle Scholar
29 Alaani, A, Warfield, AT, Pracy, JP. Management of laryngeal amyloidosis. J Laryngol Otol 2004;118:279–83Google Scholar
30 Yiotakis, I, Georgolios, A, Charalabopoulos, A, Hatzipantelis, P, Golias, C, Charalabopoulos, K et al. Primary localized laryngeal amyloidosis presenting with hoarseness and dysphagia: a case report. J Med Case Rep 2009;3:9049 Google Scholar
31 Gilad, R, Milillo, P, Som, PM. Severe diffuse systemic amyloidosis with involvement of the pharynx, larynx, and trachea: CT and MR findings. Am J Neuroradiol 2007;28:1557–8Google Scholar
32 Golombick, T, Diamond, TH, Manoharan, A, Ramakrishna, R. Stabilisation of laryngeal AL amyloidosis with long term curcumin therapy. Case Rep Hematol 2015;2015:1–4 CrossRefGoogle ScholarPubMed
33 Neuner, GA, Badros, AA, Meyer, TK, Nanaji, NM, Regine, WF. Complete resolution of laryngeal amyloidosis with radiation treatment. Head Neck 2012;34:748–52Google Scholar
34 Truong, MT, Kachnic, LA, Grillone, GA, Bohrs, HK, Lee, R, Sakai, O et al. Long-term results of conformal radiotherapy for progressive airway amyloidosis. Int J Radiat Oncol Biol Phys 2012;83:734–9CrossRefGoogle ScholarPubMed
35 Ghosh, D, Allgar, V, Elliott, MW. Identifying poor compliance with CPAP in obstructive sleep apnoea: a simple prediction equation using data after a two week trial. Respir Med 2013;107:936–42CrossRefGoogle ScholarPubMed
36 Graamans, K, Lubsen, H. Clinical implications of laryngeal amyloidosis. J Laryngol Otol 1985;99:617–23Google Scholar
37 Ma, L, Bandarchi, B, Sasaki, C, Levine, S, Choi, Y. Primary localized laryngeal amyloidosis: report of 3 cases with long-term follow-up and review of the literature. Arch Pathol Lab Med 2005;129:215–18Google Scholar