Hellquist H, Olofsson J, Sökjer H, Odkvist L M
Acta Otolaryngol. 1979;88(5-6):443-50. doi: 10.3109/00016487909137191.
Amyloidosis of the larynx is a rare disease, accounting for less than 1% of all benign laryngeal 'tumours'. Three cases of this type of lesion are reported--one of the vocal cord, one of the false vocal cord and one of the subglottis and trachea. In 2 of the patients the amyloidosis was localized, while the third was later found also to have an epipharyngeal solitary plasmacytoma with amyloid deposits and in addition amyloidosis of the nasal cavity. However, the amyloidosis in this patient may still be regarded as being localized, as the clinical examination and laboratory tests afforded no evidence of generalized disease. Amyloidosis of the larynx may be manifested as a localized tumour or as a diffuse infiltration. The symptoms and signs will, of course, depend on the site of the amyloid deposit. When the vocal cords are involved hoarseness may result, and this was the most prominent sign in the present cases. The treatment of laryngeal amyloidosis is primarily by endoscopic excision. Amyloid substance has specific staining properties. The Congo red reaction with a green birefringence in polarized light and Phorwhite BBU using fluorescence microscopy are regarded as the most reliable staining reactions. Electron microscopy has revealed a typical fibrillar structure of amyloid.
喉淀粉样变性是一种罕见疾病，占所有良性喉部“肿瘤”的比例不到1%。本文报告了3例此类病变——1例位于声带，1例位于假声带，1例位于声门下和气管。其中2例患者的淀粉样变性为局限性，而第3例患者后来还被发现患有咽上孤立性浆细胞瘤伴淀粉样沉积，此外鼻腔也有淀粉样变性。然而，该患者的淀粉样变性仍可被视为局限性，因为临床检查和实验室检查均未提供全身性疾病的证据。喉淀粉样变性可表现为局限性肿瘤或弥漫性浸润。症状和体征当然取决于淀粉样沉积的部位。当声带受累时可能会导致声音嘶哑，这是目前病例中最突出的体征。喉淀粉样变性的治疗主要通过内镜切除。淀粉样物质具有特定的染色特性。刚果红反应在偏振光下呈绿色双折射以及使用荧光显微镜的Phorwhite BBU被认为是最可靠的染色反应。电子显微镜已揭示淀粉样物质具有典型的纤维结构。
