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Differential diagnosis of laryngeal carcinoma
1. Nodular laryngitis (also known as vocal nodules)
Its manifestations are small gap hoarseness, aggravation in the evening, lighter in the morning, throat dryness, slight pain and increased laryngeal secretion, which tend to occur at the junction of anterior middle 1/3 and middle 1/3 of vocal cords, with symmetrical mucosal nodules at the free margin, edema-like, smooth surface, grain-like size and wide hyperemia at the base. Rest can reduce vocalization, atomization inhalation, ultrashort wave physiotherapy and proper antibiotic treatment are effective. Larger ones should be removed under laryngoscope.
2. Adam's apple nucleus
Patients with Adam's apple nucleus have different degrees of sore throat, and most of them have tuberculosis foci coexisting in the lungs. The lesion is granular, pink or pale edema, often accompanied by shallow ulcer, covering purulent secretion, and the posterior union is the prone site of Adam's apple nucleus, while laryngeal cancer is rare. Antituberculosis treatment is effective, biopsy cytology, secretion smear and acid-fast bacilli are helpful for diagnosis.
3. Laryngeal keratosis and leukoplakia
It is characterized by dumb throat discomfort, which is common in men over middle age. Laryngoscope shows thickening of vocal cords, showing pink or white plaques. Inflammatory reactions often occur in surrounding tissues, mostly unilateral, and bilateral vocal cords can also be involved, which is easy to recur and tends to malignant transformation. Pathological biopsy can confirm the diagnosis.
4. Papilloma of Laryngeal Carcinoma
This disease occurs frequently in children and can be seen in adults. At present, it is considered to be caused by virus infection, often complicated with skin warts, and there is no difference between men and women. The main performance is dumb. Laryngoscope shows that children often suffer from diseases in various parts of larynx, with pedicles and wide basement, showing cauliflower shape. Adults with single pedicle, often in vocal cords, activity is not limited, mostly male, lesions are limited, pathological examination shows severe atypical hyperplasia, should be completely removed to prevent malignant transformation.
5. Laryngeal amyloidosis
Its clinical manifestations are mild hoarseness, sometimes wheezing-like dyspnea. The lesions tend to occur in the anterior larynx under glottis, and can also occur in ventricular zone and vocal cords, showing single or multiple nodules, or diffuse thickening of mucosa, rarely fixed vocal cords, long course of disease, positive amyloid Congo red in pathological examination, and sensitive to corticosteroids in diffuse lesions.
6. Wegener's granuloma
The clinical manifestations of this disease are silent, laryngeal ulcer, secondary infection, often accompanied by dyspnea, and the pathological tissues are necrotizing granulation, vasculitis and scattered giant cells and inflammatory cell infiltration. There are often lung and kidney diseases. Pathological examination is needed to confirm the diagnosis.
7. Benign mixed tumor of larynx
This disease is rare, comes from small salivary glands, and occurs in arytenoid-epiglottic fold or supraglottic area. The surface mucosa is smooth, the boundary is clear, the tumor is solid, and the lateral X-ray film of the neck shows the shadow of the mass with smooth boundary, which is of great significance for the diagnosis by pathological examination.
8. Laryngotracheal thyroid
Rare, the thyroid gland is longer in trachea through cartilage in embryonic stage, which is more common in the posterior wall of trachea in subglottic area, and the tumor part is outside trachea, which is more common in middle-aged women with endemic goiter. It is characterized by progressive dyspnea, aggravated menstruation and normal vocalization. X-ray film shows soft tissue shadow protruding into tracheal cavity. 131I scan showed iodine uptake in the tumor area.
9. Benign granulosa cell tumor of larynx
This disease usually occurs in 29-42 years old. The lesions are located in vocal cords, with dumb symptoms. The diameter of smooth nodules in mucosa is less than 1cm, the boundary is unclear, and the activities of vocal cords are not limited, so it needs pathological examination to confirm the diagnosis.
10. Laryngeal plasmacytoma
This disease is rare, occurs in middle-aged and elderly men, and occurs in various parts of larynx, especially epiglottis, vocal cords, ventricular zones and laryngeal chambers. The laryngoscope showed diffuse submucosal tumor infiltration in the larynx, which often exceeded the larynx and involved the pharynx. Pathological biopsy was of differential significance.
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