Diagnosis Of Laryngeal Tuberculosis Research Articles

Tuberculosis in Larynx

Introduction: Laryngeal tuberculosis (TB) has shown increase in incidence in recent years and the increase in immunosuppressive conditions has altered the clinical profile of the disease. The aim of this study was to evaluate the changing trends of laryngeal TB and to highlight its site of involvement, type of lesion, and degree of involvement. Patients and Methods: This prospective study included 54 patients with a diagnosis of laryngeal TB. All patients were evaluated in terms of their age, chief complaints, lesions, and site of involvement on flexible fiber-optic bronchoscopy, and they also underwent a variety of laboratory investigations as indicated. Results: The study showed that true vocal cords + false cords + epiglottis were involved in 48.1% (n = 26), arytenoids + interarytenoid + posterior part of true cords in 24.1% (n = 13), true cords + false cords + arytenoids + interarytenoid in 18.5% (n = 10), true vocal cords alone in 5.5% (n = 3), interarytenoid in 1.8% (n = 1), and interarytenoid + arytenoid involvement was seen in 1.8% (n = 1) of patients. These lesions were categorized into four different appearances as follows: granulomatous lesions in 50% (n = 27), ulcerative lesions in 27.7% (n = 15), hyperemia and hypertrophic in 16.7% (n = 9), and papillomatous mass in 5.6% (n = 3) based on fiber-optic bronchoscopy. Conclusion: In this study, the disease was most rampant in the age group of 31–60 years, with a predilection seen in low socioeconomic groups, rural groups and in individuals addicted to smoling and alcoholism. Hoarseness and odynophagia are the major symptoms. Multiple subsites are involved, and the lesions show a predilection for the anterior part of the vocal cord.

Appearance and morphologic features of laryngeal tuberculosis using laryngoscopy: A retrospective cross-sectional study.

Laryngeal tuberculosis (LTB) is highly contagious and can cause permanent laryngeal damage. Therefore, correctly identifying laryngoscopic LTB lesion locations, sizes, and morphologic features are essential for LTB diagnoses. This study aimed to explore the appearance and morphologic features of LTB and correlated these features with clinical symptoms.We retrospectively analysed 39 LTB patients in our hospital between January 2013 and December 2019. Medical records, including clinical presentation, lesion appearance (locations, sizes, and morphology), complementary examination results, and histopathologic features were summarized and analysed.In this patient cohort, dysphonia and sore throat were the two most common clinical symptoms. In LTB patients with extensive lesions, ulcerative lesions were most common, and the proportion of cases with concurrent pulmonary tuberculosis (86.4%, P = .033) infection was higher, as were the positive rates of sputum smears (72.7%, P = .011) and cultures (86.4%, P = .002) than patients without concurrent pulmonary TB and with more localized and exophytic lesions. The histopathologic features of LTB-related ulcerative lesions included fewer granulomas and more areas with caseous necrosis. These lesions were more likely to have acid-fast bacilli detected with a Ziehl–Neelsen stain than exophytic lesions that rarely showed detectable bacilli.A complete knowledge regarding the visual and morphologic features of LTB on laryngoscopy is needed for the early detection and diagnosis of LTB. Our study revealed the lesion sites, sizes, and morphologic features of LTB. These parameters were also correlated with patient clinical symptoms. Future studies are needed to support and expand the results of this retrospective study.

Diagnosis of laryngeal tuberculosis in a high TB burden area.

The larynx is the second most commonly affected site in the head and neck region in patients with extrapulmonary tuberculosis (TB). Despite this, the prevalence of laryngeal TB is largely unknown, particularly in areas with a high TB burden. The laboratory diagnosis of TB includes microscopy, culture and molecular testing. The aims of this study were to determine the prevalence of laryngeal TB in patients presenting with laryngeal pathology in a region with a high TB burden and to determine the optimal diagnostic methods for the diagnosis of laryngeal TB. This was a prospective descriptive study of 80 adult patients undergoing direct laryngoscopy and biopsy for laryngeal pathology in the Department of Otorhinolaryngology, Universitas Academic Hospital, Bloemfontein, South Africa over a 1year period. Histopathological and microbiological investigations (microscopy, Xpert MTB/RIF, and TB culture) were performed on all laryngeal biopsies. Five (6.25%) out of 80 patients were diagnosed with laryngeal TB. In one patient, the Xpert MTB/RIF assay was positive on the laryngeal tissue and histology showed granulomas. Two patients had granulomas on histology although the microbiological tests on the tissue were negative. Two patients had only positive tissue cultures for Mycobacterium tuberculosis. None of the biopsies had positive Ziehl-Neelsen stains. The results suggest that the diagnosis of laryngeal TB required a combination of histopathology, culture and PCR and that the Xpert MTB/RIF assay is not a sensitive test for the diagnosis of laryngeal TB.

Primary Laryngeal Tuberculosis: A Series of 15 Cases.

Tuberculosis usually involves the lungs, but can also involve various other organs. Extra pulmonary tuberculosis is very rarely confined to the larynx in the absence of an associated pulmonary lesion. In this retrospective study, clinicopathological characteristics of patients with final diagnosis of laryngeal tuberculosis (LTB) were reviewed. The diagnosis of LTB was based on: (1) the existence of chronic granulomatous inflammation with caseous necrosis in the histopathology of laryngeal lesions or (2) the presence of laryngeal lesions with atypical histopathology (chronic granulomatous inflammation) which had a complete response to anti-tuberculosis therapy. Fifteen cases with a diagnosis of LTB were collected. The patients' age ranged between 24 and 75years with a mean of 49years. On laryngoscopy, 66.6% of cases (10/15) had an ulceroproliferative lesion while the remaining 33.3% of cases (5/15) had an exophytic growth. The pathology of laryngeal lesions revealed chronic granulomatous inflammation with caseous necrosis in nine cases and chronic granulomatous inflammation without necrosis in six cases. Nine out of 15 cases (60%) showed presence of acid-fast bacilli on Ziehl-Neelsen stain. Any evidence of pulmonary tuberculosis was ruled out by chest X-ray findings. The response to anti-tuberculosis therapy was desirable in all patients. Since the introduction of anti-tuberculous therapy, the incidence of LTB has declined. However, with the incidence of TB increasing, the overall incidence of laryngeal involvement may be on the rise. This study highlights the importance to consider the rare possibility of LTB in the presence of non-specific clinical and laryngoscopic signs and to confirm this by histological examination.

Laryngeal Tuberculosis Diagnosed in a Pathological Laboratory in Senegal (2011-2015)

Laryngeal tuberculosis (LT) is a rare disease. The therapy for LT is easy but the diagnosis remains a challenge for the pathologist and the laryngologist because of the absence of specific signs. The objective was to analyze the epidemiological and pathological profiles of LT cases in Dakar (Senegal) with a view to better understand this pathology. This study was a retrospective and descriptive of LT cases diagnosed in pathology laboratories in Senegal during five years (2011-2015). The LT was found in 9cases. The mean age at diagnosis was 41.9years (18/58) without sex predominance (sex-ratio = 0.8). Tobacco intoxication (3/9), tuberculosis contagion (1/9), HIV immunodepression (2/9), and diabetes (1/9) were the various risk factors found. Dysphonia was a constant symptom (9/9) associated with dysphagia (2/9) and cervical adenopathy (1/9). The macroscopic presentation was tumoral-like (7/9) and erythematosus and fibrinoid (2/9). The LT was of glottic seat in all the cases (9/9) with participation on top-glottic in two of the cases. The biopsy was performed in all patients. It reported tuberculous granuloma in four cases (4/9), tuberculoid granuloma in one case (1/9), and chronic lymphocytic laryngitis in four cases (4/9). CT-scan of the lungs was pathological in five patients (5/9). Evolution was favorable in all cases under "conventional tuberculosis treatment" over a period of six months. The diagnosis of LT requires a high collaboration between the laryngologist and the pathologist.

Interferon-γ release assay in the diagnosis of laryngeal tuberculosis

Conclusion: The T-SPOT test for Mycobacterium tuberculosis infection (T-SPOT.TB) can be used for early diagnosis of laryngeal tuberculosis (TB). Objective: The incidence of TB is increasing on a global scale. Laryngeal TB is the most common extrapulmonary form of TB and its early diagnosis is still difficult. This study investigated the performance of the interferon-γ release assay in the diagnosis of laryngeal TB. Methods: A total of 83 patients with laryngeal neoplasms were confirmed to have laryngeal TB by pathology, acid-fast staining, and/or fluorescence quantitative PCR. In addition, 52 patients with vocal cord polyps were enrolled as the control group. Two groups underwent both T-SPOT.TB and tuberculin skin test (TST). Results: T-SPOT.TB was positive in 75 cases in the laryngeal TB group and 4 cases in the control group, showing a sensitivity of 90.3% (75/83) and a specificity of 92.3% (48/52). The TST was positive in 42 cases and 20 cases, respectively, in these two groups. Obviously, TST and T-SPOT.TB were significantly different in terms of sensitivity when applied for detection of laryngeal TB (p < 0.05).

Twelve cases of laryngeal tuberculosis

Between 1986 and 1990 we had twelve patients (ten males, two females, 19-65 years of age) with laryngeal tuberculosis who complained hoarseness and whose larynges were examined by fiberscopes. Chest roentgenograms revealed cavities in ten and in seven the lesions were extensive (Grade 3 according to the classification of Japanese Society for Tuberculosis). In all patients sputum smears were positive. Both patient's and doctor's delays were longer than those of patients with pulmonary tuberculosis without laryngeal involvements. Group infection was the source of infection in one patient. Since the diagnosis of laryngeal tuberculosis is difficult to make on clinical basis, it is important to make fiberscopic examinations of the larynx and do biopsies in patients with pulmonary tuberculosis who complain hoarseness.

Diagnosis of Laryngeal Tuberculosis in a Patient with a Supraglottic Mass

Diagnosis of Laryngeal Tuberculosis in a Patient with a Supraglottic Mass

Symptoms and diagnosis of laryngeal tuberculosis

Symptoms and diagnosis of laryngeal tuberculosis