Laryngeal sarcoidoisis – a case report

Abstract

Introduction. Sarcoidosis is a multi-organ disease characterized by noncaseating granulomas. The lesions are usually localized within the lungs and hilar lymph nodes. The sarcoidosis of the upper respiratory tract (SURT) rate is estimated at 0.5-6%. The involvement of the larynx is extremely rare - it occurs in 1.2% of cases of SURT. Materials and methods. We present a case of a patient with laryngeal sarcoidosis. Results. A 48-year-old man had had a diagnosed of dysphonia for 5 years. A diagnosis of chronic hypertrophic laryngitis was made. Empirical course of methylprednisolone was attempted with a short-term improvement. Due to coexisting skin lesions, he was diagnosed with allergy. Chest CT showed moderately enlarged mediastinal and hilar lymph nodes as well as bilateral nodules around the hila. The bronchial biopsy showed no granulomas. Samples taken during microlaryngoscopy revealed sarcoid infiltrates. Conclusions and discussion. There is no unambiguous test confirming the diagnosis of sarcoidosis. It is a typical example of a diagnosis by exclusion. Laryngeal involvement is extremely rare and occurs in 1.2% of cases of SURT. The clinical course of the disease is often difficult to predict. In many patients, the lesion may undergo spontaneous regression. In patients poorly responding to steroid therapy or developing side effects, cytotoxic drugs may be considered.