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Clinical Problem Solving: Pathology
July 2012

Pathology Quiz Case 2: Diagnosis

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Arch Otolaryngol Head Neck Surg. 2012;138(7):690-691. doi:10.1001/archotol.138.7.690

Diagnosis: Multifocal amyloidosis of the supraglottic and glottic larynx

Amyloidosis of the head and neck is a rare disease, and the larynx is the most frequent site of involvement. Only 11 cases of laryngeal amyloidosis were retrieved from a review of the Head and Neck Tumor Registry from 1953 to 1990.1 A review of the 15 cases of head and neck amyloidosis that were identified in the surgical pathology files of Emory University Hospital, Atlanta, Georgia, from 1985 to 2005 revealed that only 3 had laryngeal involvement.2 While amyloidosis of the head and neck is most frequently localized and idiopathic, up to 15% of these lesions are multifocal.3 In contrast, it has been reported that up to 90% of patients with systemic amyloidosis develop concurrent amyloid deposits in the head and neck.4 While amyloidosis in the head and neck most commonly presents in the larynx (61%), other sites of involvement include the oropharynx (23%), trachea (9%), orbit, nasopharynx, and thyroid.5

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