Humans ; Laryngeal Neoplasms ; Larynx ; Rhabdomyoma/diagnostic imaging*

Esophageal Neoplasms/diagnostic imaging* ; Humans ; Laryngeal Neoplasms/diagnostic imaging* ; Laryngoscopes ; Narrow Band Imaging ; Neoplasms, Multiple Primary

Humans ; Laryngeal Neoplasms/diagnostic imaging* ; Laryngoscopes ; Narrow Band Imaging ; Papilloma/diagnostic imaging*

OBJECTIVETo assess the clinical value of (18)F-FDGPET/CT in the diagnosis of larynx carcinoma. Methods Forty-seven patients with larynx carcinoma or suspected larynx carcinoma underwent (18)F-FDG PET/CT examination within a week before therapy. The value of (18)F-FDG PET/CT in the diagnosis and staging of the malignancy was compared with that of unenhanced contrast CT.

METHODSForty-seven patients with larynx carcinoma or suspected larynx carcinoma underwent (18)F-FDG PET/CT examination within a week before therapy. The value of (18)F-FDG PET/CT in the diagnosis and staging of the malignancy was compared with that of unenhanced contrast CT.

RESULTSAmong the 47 patients, a definite diagnosis of larynx carcinomas was established pathologically in 43 patients. For detection of primary tumors, the sensitivity, specificity and accuracy of (18)F-FDG PET/CT were 95.3%, 75% and 93.6%, as compared with 74.4%, 50%, and 72.3% with unenhanced contrast CT scan, respectively, showing significant differences in the diagnostic sensitivity and accuracy between the two modalities (Χ=7.340, P=0.007; Χ=7.532, P=0.006). Twenty-six of the 43 patients were identified to have lymph node metastasis, for which (18)F-FDG PET/CT showed a significantly higher diagnostic sensitivity than unenhanced contrast CT (92.3% vs 61.5%, Χ=6.933, P=0.008). In the 46 excised lymph nodes from 19 patients, 26 were found positive for metastasis, for which (18)F-FDG PET/CT showed a diagnostic sensitivity of 92%, significant higher than that with unenhanced contrast CT (64%, Χ=5.71, P=0.017). PET/CT detected synchronous tumor in one case. (18)F-FDG PET/CT resulted in a change of staging in 34.9% of the patients, including upstaging in 14 patients and down-staging in one patient.

CONCLUSION(18)F-FDG PET/CT can be an important means for diagnosis and initial staging of larynx carcinoma.

Adult ; Aged ; Carcinoma ; diagnostic imaging ; Female ; Fluorodeoxyglucose F18 ; Humans ; Laryngeal Neoplasms ; diagnostic imaging ; Middle Aged ; Multimodal Imaging ; methods ; Positron-Emission Tomography ; Tomography, X-Ray Computed

OBJECTIVE: To investigate the value of MRI and MSCT in TNM staging of laryngocarcinoma. METHOD: Thirty-seven patients with laryngocarcinoma were underwent by contrast enhanced scan and multiplanar reconstruction. Thirty-five patients with laryngocarcinoma were underwent contrast enhanced multislice spiral CT, which of them were done by MPR. There are 28 cases which were scan by MRI and MSCT in the two former and we contrasted the accuracy rating in laryngeal manifestation of abnormality. In the former two groups, we observed them the variability in the aspect of lymphaden metastasis and TNM staging. RESULT: In all 28 cases, the MRI had better accuracy rating in displaying the parts of preepiglottic space, larynx side interspace, lingual root, neck tissue, vocal cord. In the TNM staging, there was no difference in stage one in accuracy rating, as the stag stepping up, the accuracy rating of MRI had became better. The last result was that the two methods had difference in staging. In the two methods, MSCT had better sensitivity, specificity and accuracy rating. CONCLUSION MRI and MSCT had good accuracy rating in TNM staging, MRI has better accuracy rating in some of laryngeal, but as the lymphaden metastasis, the MSCT was better. There were variability in staging, and the MRI was better.
Adult ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Tomography, Spiral Computed

Adult ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Laryngeal Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Laryngectomy ; Leiomyosarcoma ; pathology ; Male ; Rhabdomyosarcoma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Tomography, X-Ray Computed ; Vimentin ; metabolism

Extramedullary plasmacytoma of the larynx is rare, especially when coexisted with squamous cell carcinoma in situ. We report a 56-year-old woman with hoarseness for 6 months and dysphonia for a week. Fiberoptic laryngoscopic examination showed a red, smooth-surface swelling in the submucous region of the left ventricle and ventricular band of the larynx. The patient underwent vertical laryngectomy and modified left neck dissection. Postoperative pathologic examination revealed coexisting plasmacytoma and carcinoma in situ. Bone marrow biopsy and systemic radiogram showed no positive findings. The hepatic and renal functions were normal. Monoclonal immunoglobulin light chain of type kappa was detected in urine. Hence, a laryngeal extramedullary plasmacytoma with carcinoma in situ was diagnosed. No recurrence or progression was observed during a 2-year follow-up. Here, we discussed the risk factors, diagnosis, and therapy for this rare disease.
ADP-ribosyl Cyclase 1 ; metabolism ; Carcinoma in Situ ; diagnosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Carcinoma, Squamous Cell ; diagnosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Immunoglobulin A ; metabolism ; Immunoglobulin kappa-Chains ; metabolism ; Laryngeal Neoplasms ; diagnosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Laryngectomy ; Laryngoscopy ; Middle Aged ; Mucin-1 ; metabolism ; Neck Dissection ; Plasmacytoma ; diagnosis ; diagnostic imaging ; metabolism ; pathology ; surgery ; Syndecan-1 ; metabolism ; Tomography, X-Ray Computed

OBJECTIVETo study the clinicopathologic features, histologic diagnosis and differential diagnosis of primary mucosal tuberculosis (TB) in the head and neck region.

METHODSForty-seven cases of primary mucosal TB of the head and neck region were studied by hematoxylin-eosin and Ziehl-Neelsen stains. The clinical and pathologic features were analyzed with review of the literature.

RESULTSThe patients included 26 male and 21 female, with mean age 47.1 years (range 14-84 years). There were three sinonasal TB, 19 nasopharyngeal TB, two oropharyngeal TB, 18 laryngeal TB, four middle ear TB, one salivary gland TB and one laryngeal TB complicating laryngeal cancer. The initial symptoms were nasal obstruction, mucopurulent rhinorrhea, epistaxis, snoring, hoarseness, dysphagia, odynophagia, serous otitis, hearing loss, tinnitus, and otalgia. Physical examination result was variable, from an apparently normal mucosa, to an evident mass, or a mucosa with an adenotic or swollen appearance, ulcers, leukoplakic areas, and various combinations thereof. CT and MRI findings included diffuse thickening, a soft-tissue mass, calcification within the mass and bone destruction resembling malignancy. Histologic examination showed granulomas with a central necrotic focus surrounded by epithelioid histiocytes and multinucleated Langhan's giant cells. Acid-fast bacilli were difficult to demonstrate but found in 13/45 cases. Follow-up data were available in 42 patients.

CONCLUSIONSPrimary TB arising in the head and neck mucosa is rare. It may mimic or co-exist with other conditions. The characteristic histopathology is a granuloma with central caseous necrosis and Langhans'giant cells. Identification of acid-fast bacilli and bacteriologic culture confirm the diagnosis of mycobacterial disease.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antitubercular Agents ; therapeutic use ; Carcinoma, Squamous Cell ; complications ; microbiology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Laryngeal Neoplasms ; complications ; microbiology ; surgery ; Male ; Middle Aged ; Otorhinolaryngologic Diseases ; diagnostic imaging ; drug therapy ; microbiology ; pathology ; Tomography, X-Ray Computed ; Tuberculin Test ; Tuberculosis ; diagnostic imaging ; drug therapy ; pathology ; Tuberculosis, Laryngeal ; complications ; surgery ; Tuberculosis, Oral ; drug therapy ; pathology ; Young Adult

OBJECTIVEThe purpose of this study was to investigate the clinical value of radiolabeled tracer method, methylene blue method and combination of these two methods in detection of sentinel lymph node (SLN), and to evaluate the accuracy of SLN in predicting the cervical lymph nodes status in laryngeal carcinoma patients with clinically negative neck lymph nodes (cN0 ).

METHODSForty-one patients with cN0 laryngeal neoplasms underwent SLN detection using both of radiolabeled tracer and methylene blue. SLN imaging was performed with laryngoscope-guided injection of radioactive isotope 99Tc(m)-sulfur colloid (SC) into the laryngeal carcinoma before surgery, then all these patients underwent intraoperative lymphatic mapping with a handheld gamma-detecting probe. After mapping of SLN, methylene blue was subsequently injected at the same spots around the tumor in order to identify SLN during surgery. The results of SLN detection by isotope tracer, dye and combination of both methods were compared.

RESULTSThe SLN detection rates by radiolabeled tracer, methylene blue and combined method were 87.8%, 70.7% and 92.7%, respectively (P < 0.01). The number of detected SLN was significantly different between radiolabeled tracer method and combined method (P < 0.05), and also between blue dye method and combined method (P < 0.01). However, no statistically significant difference was found between methylene blue method and radiolabeled tracer method (P > 0.05). Nine patients were found to have lymph node metastasis by final pathological examination. The sensitivity, accuracy and negative predictive values of SLN detection by the combined method using radiolabeled tracer and methylene blue were 88.9%, 97.4% and 96.7%, respectively.

CONCLUSIONThe combined method using radiolabeled tracer and methylene blue can improve the accuracy of sentinel lymph node detection. Furthermore, sentinel lymph node detection can accurately predict the cervical lymph node status in cN0 laryngeal carcinoma.

Adolescent ; Adult ; Aged ; Carcinoma, Squamous Cell ; diagnostic imaging ; pathology ; Female ; Humans ; Laryngeal Neoplasms ; diagnostic imaging ; pathology ; Larynx ; Lymph Nodes ; diagnostic imaging ; Lymphatic Metastasis ; Male ; Methylene Blue ; Middle Aged ; Neoplasm Staging ; Radiopharmaceuticals ; Technetium Tc 99m Sulfur Colloid ; Tomography, Emission-Computed, Single-Photon ; methods ; Tomography, X-Ray Computed ; Young Adult

Administration, Oral ; Bronchoscopy ; Female ; Glottis ; abnormalities ; diagnostic imaging ; Hemangioma ; congenital ; diagnosis ; therapy ; Humans ; Infant, Newborn ; Laryngeal Neoplasms ; congenital ; diagnosis ; therapy ; Propranolol ; administration & dosage ; therapeutic use ; Tomography, X-Ray Computed