Heterotopic Epiglottic Lymphoid Tissue (HELT) Causing Recurrent Epiglottitis

Abstract

Problem: A unique case of recurrent infectious epiglottitis in an immunocompetent, fully immunized, non-syndromic 23 year old female. Method: Case report Results: Patient was successfully managed with an endoscopic partial epiglottectomy at two years of follow-up. Pathology revealed what appears to be sub-mucosal germinally-active heterotropic lymphoid tissue within the epiglottic soft tissues as the likely cause of the recurrent epiglottitis. Conclusions: The embryology of the lingual tonsils and epiglottis may provide a clue to the etiology of this case. Heterotrophic epiglottic lymphoid tissue may be considered a newly described, clinically significant congenital laryngeal anomaly that may not present until adulthood and should be considered in rare cases of recurrent infectious epiglottitis.