Vocal cord nodule

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Vocal cord nodule
Diagnosis in short

Laryngeal nodule

Synonyms singer's nodule, vocal fold nodule

LM early: edema, fibroblasts proliferation; late: subepithelial hyaline / stromal hyaline, blood vessels - dilated
LM DDx amyloidosis, granular cell tumour, spindle cell squamous cell carcinoma, myxoma, ductal-type cyst
Stains congo red -ve
Site vocal cord - see head and neck pathology

Signs +/-hoarseness
Prevalence common
Prognosis benign

Vocal cord nodule, also vocal cord polyp, vocal fold nodule and singer's nodule, is a benign pathology of the head and neck.

General

  • Benign.
  • Etiology: overuse, "phonatory trauma"[1] (yelling).

Clinical:

Microscopic

Features:[3]

  • Early:
    1. Edema.
    2. Fibroblasts proliferation.
  • Late:
    1. Subepithelial hyaline / stromal hyaline.
    2. Blood vessels - dilated.

Notes:

  • No inflammation.

DDx:[4]

Images

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Left Vocal Cord Polyp, Excision:
- Stratified squamous epithelium with compact hyperkeratosis and stromal 
  edema, consistent with benign vocal cord nodule or polyp.
- NEGATIVE for malignancy.

Block letters

VOCAL CORD LESION, EXCISION:
- STRATIFIED SQUAMOUS EPITHELIUM WITH PARAKERATOSIS AND STROMAL EDEMA, CONSISTENT
  WITH BENIGN VOCAL CORD NODULE OR POLYP.
- NEGATIVE FOR MALIGNANCY.
VOCAL CORD LESION, EXCISION:
- STRATIFIED SQUAMOUS EPITHELIUM WITH PARAKERATOSIS AND SUBEPITHELIAL 
  HYALINE MATERIAL, CONSISTENT WITH WITH VOCAL CORD NODULE OR POLYP.
- NEGATIVE FOR MALIGNANCY.

See also

References

  1. Karkos, PD.; McCormick, M. (Dec 2009). "The etiology of vocal fold nodules in adults.". Curr Opin Otolaryngol Head Neck Surg 17 (6): 420-3. doi:10.1097/MOO.0b013e328331a7f8. PMID 19730264.
  2. Müller, R. (Nov 1995). "[Hoarseness].". Ther Umsch 52 (11): 759-62. PMID 7502253.
  3. URL: http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970310-2. Accessed on: 4 February 2011.
  4. Thompson, Lester D. R. (2006). Head and Neck Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 9. ISBN 978-0443069604.
  5. Soylu, L.; Aydogan, B.; Tunali, N.; Ozsahinoglu, C. (Aug 1999). "Report of a rare case of vocal fold carcinoma that was obscured by a prominent vocal fold polyp.". Ear Nose Throat J 78 (8): 601-2. PMID 10485155.
  6. Abdou, AG.; Asaad, NY. (Oct 2012). "Rheumatoid nodule of the vocal cord.". Int J Surg Pathol 20 (5): 481-2. doi:10.1177/1066896912448426. PMID 22674917.