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Abstract

Scleroma of the larynx is a rare specific granulomatous disease and is usually presented as a laryngeal extension of a primary rhinoscleroma. We report an unusual case of laryngeal scleroma in a 64-year-old female patient whose presented with progressive upper respiratory obstructive symptoms lasted for 2 years. Symptoms were acutely exaggerated during the course of one month. On physical examination, the nasal mucosa was atrophic and crusted, and septal perforation was noted. The fiberoptic laryngoscopy revealed a yellowish granulated epiglottic mass with a dirty surface mimicking laryngeal cancer. Histological sectioning showed the characteristic features of scleroma including Mikulicz cells with scattered plasma cells and some neutrophils. Warthin-starry stains and electron microscopy examination showed numerous short rods inside the cytoplasm of the Mikulicz cells. After the diagnosis, the patient underwent an emergency tracheostomy followed by long-term antibiotic treatment, and her symptoms have slowly improved.