Laryngeal tuberculosis

Case contributed by Dalia Ibrahim
Diagnosis almost certain

Presentation

Hoarseness of voice, dysphonia and productive cough.

Patient Data

Age: 30 years
Gender: Male
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Diffuse irregular mucosal thickening and enhancement involving the supraglottic and glottic larynx, with thickening of the epiglottis and aryepiglottic folds as well as vocal cords,more on the right side. Laryngeal cartilage is preserved.

The upper chest cuts showed bilateral apical consolidative patches, large cavities, and tree-in-bud and nodular densities

Case Discussion

The patient tested positive for TB, 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's 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 TB 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 TB is the integrity of laryngeal cartilage with the absence of destruction or sclerosis, which differentiates this from laryngeal cancer. Also preserved preepiglottic and para laryngeal fat spaces are common in laryngeal TB.

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