Primary localized laryngeal amyloidosis: report of 3 cases with long-term follow-up and review of the literature.
BACKGROUND
Localized laryngeal amyloidosis is an uncommon condition with limited long-term follow-up studies. The precise etiology and pathogenesis are not entirely clear.


OBJECTIVE
To further characterize the histopathologic features and possible pathogenesis of localized laryngeal amyloidosis.


METHODS
Three cases of primary localized laryngeal amyloidosis were identified at our institutions from 1980 to 2003. The clinical features and histologic and immunohistochemical patterns were evaluated. Systemic workups were pursued during the long-term follow-up.


RESULTS
The common presentation of the patients was hoarseness. The lesions involved vocal cords, anterior commissure, and ventricle. Microscopically, the amyloid was present within the submucosa with an adjacent lymphoplasmacytic infiltrate. The plasma cells and amyloid demonstrated monoclonal light chain restriction in all 3 cases (2 lambda, 1 kappa). No evidence of systemic amyloidosis or an overt B-cell lymphoma was found in these patients. Two patients with long-term follow-up underwent subsequent surgical removals for multiple recurrences, which occurred within 1 year of the initial diagnosis.


CONCLUSIONS
The demonstration of monoclonal light chain expression in the plasmacytic infiltrate and amyloid component in the absence of systemic lymphomas indicates that localized laryngeal amyloidosis may represent a form of benign monoclonal plasma cell dyscrasia. A close follow-up of the patients may be indicated for early detection of recurrences.
Ma
Linglei
L
Department of Pathology, Yale University School of Medicine, New Haven, CN, USA. lingleim@yahoo.com <lingleim@yahoo.com>
Bandarchi
Bizhan
B
Sasaki
Clarence
C
Levine
Steven
S
Choi
Young
Y
D000328:Adult; D000686:Amyloidosis / Q000175:diagnosis*; D005500:Follow-Up Studies; D006801:Humans; D007818:Laryngeal Diseases / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D013995:Time