Laryngo-tracheobronchial amyloidosis: a case report and review of literature

Abstract

Amyloidosis is a spectrum of diseases characterized by abnormal extracellular accumulation of proteinaceous material; its precise etiology still remains unclear. It may affect multiple organs, of which the commonest sites are larynx, bronchus and kidney. Laryngeal amyloidosis is usually a localized phenomenon rarely associated with systemic involvement, here we report a case of laryngeal amyloidosis with tracheobronchial involved. The patient was 31-years old. He had a history of open surgical operation for laryngeal amyloidosis in the left ventricle 4-years ago. This time he was suffered by amyloid deposition in his right ventricle, the lesion was excised on staged laryngoscopy under general anesthesia. After 20-months follow-up, the post-operative recovery was wonderful. The bronchoscopy examination and computerized tomography scan for chest demonstrated he also had right main bronchus amyloidosis. Being of no dyspnea, he was unwilling to accept an operation on bronchus. Though amyloidosis is a benign lesion, up to date, there are no curable treatments for such a disease, for severe cases, it may be fatal as a result of airway obstruction or respiratory failure. Here we review the pertinent references on this subject, and discuss the main managements for amyloidosis on larynx and bronchus.

Keywords: Larynx; amyloidosis; management; tracheobronchus.

Figure 1

A. Laryngoscopy image showing mass of amyloid on the right ventricle. B. Laryngoscopic examination 18 months postoperatively shows no evidence of recurrence.

Figure 2

CT scan of the chest revealing circumferential thickening with partial calcification of the right main bronchus.