A rare manifestation of a multisystemic disease: a case of vocal cord palsy secondary to sarcoidosis.
We describe a rare case of recurrent laryngeal nerve neuritis secondary to sarcoidosis. A 40-year-old woman presented with persistent dysphonia. This was her first episode of dysphonia with no reports of laryngeal trauma. Fibre-optic laryngoscopy revealed a normal nasal passage, nasopharynx and pharynx. The supraglottic structures were all unremarkable; however, inspection of the true vocal cords revealed a left vocal cord palsy that was identified as being in a paramedian position. Radiological investigation showed mediastinal adenopathy that measured up to 20 mm in the short axis diameter. Histological examination showed granulomatous lymphadenitis of the lymph node with a central area of sclerosis surrounded by discrete, non-caseating granuloma. Stains for acid-fast bacilli were negative. The morphological features were suggestive of sarcoidosis. The lymphadenopathy distribution and size did not suggest left recurrent laryngeal nerve compression, giving a subsequent diagnosis of recurrent laryngeal nerve neuritis secondary to sarcoidosis.
Royal Albert Edward Infirmary, Manchester, Manchester, UK.
Saleem
S
Mastan
Royal Albert Edward Infirmary, Manchester, Manchester, UK.
Rajeev
R
Advani
Royal Albert Edward Infirmary, Manchester, Manchester, UK.
Nicola
N
Stobbs
Department of ENT, Royal Albert Edward Infirmary, Wigan, UK.
Nirmal
N
Kumar
D000328:Adult; D005260:Female; D006801:Humans; D008206:Lymphatic Diseases / Q000150:complications* / Q000175:diagnosis; D009443:Neuritis / Q000209:etiology*; D012009:Recurrent Laryngeal Nerve; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis; D014826:Vocal Cord Paralysis / Q000209:etiology*