Solitary Plasmacytosis of the Larynx in a Patient With Non-Hodgkin’s Lymphoma Li-Ang Lee, MD, Tuan-Jen Fang, MD, and Hsueh-Yu Li, MD Solitary plasmacytosis of the larynx is a clinically unusual event. It may cause hoarseness or airway obstruction and usually needs surgical excision. Plasmacytosis is distinguished from extramedullary plasmacytoma (EMP) in that the latter primarily involves the head and neck and needs more intensive therapy such as radiotherapy. Many reports have described the histopathology and immunohistochemistry of EMP of the larynx; however, no literature in English has described solitary plasmacytosis of the larynx. We report a 44-year-old female patient with non-Hodgkin’s lymphoma and systemic lupus erythromatosus with Sjo ¨ gren’s syndrome. She complained of 1-year period of hoarseness that became exacerbated in the most recent 3 weeks. A wide-base and smooth-surface mass at the left supraglottic area was noted by direct laryngoscope. Computed tomography scan revealed a well-defined radiopaque mass. The histopathology of a specimen excised by carbon dioxide laser– assisted laryngomicrosurgery was interpreted initially as plasmacytoma. Immunohistochem- ical staining for kappa and lambda light chains demonstrated polyclonal plasma cells, and the definitive diagnosis was plasmacytosis. After 6 months follow-up, the subjective quality of her voice improved. Laryngoscopic examination revealed no evidence of recurrence. (Am J Otolaryngol 2002;23:316-320. Copyright 2002, Elsevier Science (USA). All rights reserved.) Lymphoproliferative disorders of the head and neck region represent a wide spectrum of disease, and a tissue diagnosis is required. 1 Therefore, otolaryngologists should be famil- iar with all types of lymphoproliferative dis- orders so that they can determine the modal- ity of treatment and duration of follow-up for such patients. Most of these diseases require medical treatment, surgery, chemotherapy, or radiotherapy; however excision of extramed- ullary plasmacytoma (EMP) has a better prog- nosis than radiotherapy. 2 Plasma cell disorder of the larynx is an unusual event. The incidence of laryngeal in- volvement by the hemopoietic tumor of the larynx has been estimated to be less than 1%. 3 Only 2 cases of mucous membrane plasmacy- tosis with isolated involvement of the larynx have been reported. 4 Numerous articles dis- cussing EMP have emphasized the impor- tance of differentiating it from plasmacytosis, but no articles the characteristics of solitary plasmacytosis of the larynx have been pub- lished. We briefly describe this rare case and discuss this unusual disease. CASE REPORT A 44-year-old female patient complained of a longstanding hoarseness of more than 1 year that had worsened in the most recent 3 weeks. No odynophagia, dysphagia, shortness of breath, exertional dyspnea, or neck mass was noted. The patient had a history of systemic lupus erythromatosus with Sjo ¨gren’s syn- drome, which had been under control with steroids for 7 years. The patient also had non- Hodgkin’s lymphoma (marginal zone B cell with progression to large B cell, stage IV A ) postchemotherapy (cyclophosphamide, doxo- rubicin, vincristine, prednisolone) with com- plete remission for 1 year. Lymphoma in- volvement of the mediastinum had resulted in paralysis of the left vocal cord. At the time of presentation, physical exam- ination revealed a submucosal mass in the left supraglottic larynx that had extended to the epiglottis and paralyzed the left vocal cord. A contrast-enhanced computed tomography From the Department of Otolaryngology, Chang Gung Memorial Hospital, and Chang Gung University, Taoyuan, Taiwan. Address reprint requests to Hsueh-Yu Li, MD, Depart- ment of Otolaryngology, Chang Gung Memorial Hospi- tal, 5, Fu-Shin Street, Kueishan, Taoyuan, Taiwan, R.O.C. Copyright 2002, Elsevier Science (USA). All rights reserved. 0196-0709/02/2305-0014$35.00/0 doi:10.1053/ajot.2002.124196 316 American Journal of Otolaryngology, Vol 23, No 5 (September-October), 2002: pp 316-320