Presentation
Hoarseness of voice and productive cough.
Patient Data
Diffuse circumferential mucosal thickening and enhancement involving the glottic and to a lesser extent the supraglottic larynx, with thickening of the vocal cords and to a lesser extent the epiglottis, and aryepiglottic folds. Laryngeal cartilage, pre-epiglottic, and para laryngeal fat are preserved. No masses.
The upper chest cuts showed right apical consolidative patches and large cavities.
Case Discussion
The patient tested positive for tuberculosis, also laryngoscopy and biopsy confirmed granulomatous inflammatory process, with no evidence of malignancy.
Laryngeal tuberculosis is a rare presentation of tuberculosis. It can mimic laryngeal carcinoma,
It is caused either by pooling of infected secretions in the posterior larynx or hematogenous spread to the anterior larynx.
The patient usually presents with hoarseness of voice, cough, and odynophagia.
Laryngeal tuberculosis manifests as diffuse circumferential symmetric or asymmetric mucosal thickening involving the glottis or supraglottis. The supraglottic larynx is the most involved site, mainly the aryepiglottic fold, the next common sites are the free margin of epiglottis, the false and true vocal cords. The characteristic sign of laryngeal tuberculosis is the integrity of laryngeal cartilage with the absence of destruction or sclerosis, which differentiates this from laryngeal cancer. Also preserved pre-epiglottic and para laryngeal fat spaces are common in laryngeal TB.
Case courtesy of Dr. Lobna Mohamed.
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