title: Primary laryngeal cryptococcosis resembling laryngeal carcinoma.
abstract: A case of an 82-year-old female with primary laryngeal cryptococcosis who had undergone long-term corticosteroid therapy for chronic obstructive pulmonary disease and rheumatoid arthritis is reported. She complained hoarseness with swallowing pain and irritability of the larynx for over a month. Endoscopic examination revealed a white, exudative irregular region on right arytenoid that mimicked a laryngeal carcinoma. Histological examination showed pseudoepitheliomatous hyperplasia and severe submucosal inflammation with ovoid budding yeasts by Grocott's stain. A serological study indicated a high titer of cryptococcal antigen. After treating with oral fluconazole for 3 months, her primary lesion of larynx turned to be clear. We implicate a long-term use of steroids as the significant risk factor in developing cryptococcosis of the larynx.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Tamagawa
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan. Electronic address: mhotomi@wakayama-med.ac.jp.
authors.forename: Muneki
authors.initials: M
authors.lastname: Hotomi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Yuasa
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tuchihashi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Yamauchi
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Togawa
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama, Japan.
authors.forename: Noboru
authors.initials: N
authors.lastname: Yamanaka
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000188:drug therapy; D002277:Carcinoma / Q000175:diagnosis*; D003453:Cryptococcosis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007822:Laryngeal Neoplasms / Q000175:diagnosis*; D007827:Laryngitis / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents
keywords: Cryptococcus neoformans; Immunocompromised host; Laryngeal tumor; Larynx