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Clinical Challenge
September 2015

Waxy Laryngeal Mass

Author Affiliations
  • 1Department of Otolaryngology–Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
  • 2Department of Pathology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
JAMA Otolaryngol Head Neck Surg. 2015;141(9):853-854. doi:10.1001/jamaoto.2015.1491

A woman in her 60s presented with a history of persistent globus pharyngis spanning 2 decades. She stated that she had no other symptoms, and her family medical history was not remarkable. On examination, the rigid indirect laryngoscopy revealed yellowish floppy granular proliferation affecting the bilateral arytenoids and posterior aspects of the aryepiglottic folds, with symmetrical vocal cord motion (Figure, A). The main lesions were clearly demarcated from the surrounding normal mucosa. The patient then underwent microlaryngeal surgery with biopsy under general anesthesia. The nidus was fragile and bled copiously when traumatized. The specimens mounted on the hematoxylin-eosin slides showed eosinophilic amorphous material underlying the epithelium (Figure, B). Staining for thioflavin T revealed yellow-green fluorescence (Figure, C). The fibrillar component emitted a characteristic apple-green birefringence under polarized light after binding to Congo red dye. No clinical evidence of systemic involvement and/or plasma cell dyscrasia was found.

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