2024-03-29T02:01:03Z
https://nagoya.repo.nii.ac.jp/oai
oai:nagoya.repo.nii.ac.jp:02004218
2023-04-28T06:33:57Z
499:508:509:1669094631719
Primary laryngeal cryptococcosis mimicking laryngeal malignancy: a case report
Tonai, Kazuya
Nishio, Naoki
Yokoi, Sayaka
Kobayashi, Masumi
Sone, Michihiko
laryngeal cryptococcosis
yeast-like fungus
Alcian blue stain
fluconazole
inhaled corticosteroid
Primary laryngeal cryptococcosis is an extremely rare infection and presents with non-specific symptoms such as hoarseness or sore throat, resulting in delayed diagnosis. Here, we report the patient of a 56-year-old female patient with primary laryngeal cryptococcosis, who was being treated with oral and inhaled steroids for rheumatoid arthritis and bronchial asthma. The patient suffered from prolonged hoarseness and sore throat, and endoscopic biopsy was performed several times under local anesthesia, demonstrating only inflammatory cell infiltration. Considering the possibility of laryngeal malignancy, a third biopsy was performed by endoscopic laryngomicrosurgery under general anesthesia. Intraoperative frozen section revealed non-neoplastic laryngeal mucosa with erosion and severe inflammatory cell infiltration. However, we could not confirm the definite diagnosis of the lesion in the intraoperative consultation. Postoperative histopathological examination revealed a small number of yeast-type fungi and a definitive diagnosis was established by special stains including Alcian blue stain. Finally, the patient was diagnosed as primary laryngeal cryptococcosis. Daily oral administration of fluconazole (400 mg/day) was performed for 6 months according to the treatment protocol for pulmonary cryptococcosis. The symptoms gradually improved, and endoscopy revealed no recurrence 6 months post-treatment. Clinicians should consider the possibility of laryngeal cryptococcosis when severe inflammation is found in the larynx and discuss the disease history and pathological results with pathologists more closely.
departmental bulletin paper
Nagoya University Graduate School of Medicine, School of Medicine
2022-11
application/pdf
Nagoya Journal of Medical Science
4
84
900
905
0027-7622
2186-3326
https://nagoya.repo.nii.ac.jp/record/2004218/files/22_Tonai.pdf
eng
https://www.med.nagoya-u.ac.jp/medlib/nagoya_j_med_sci/844.html
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