Sinus Histiocytosis with Massive Lymphadenopathy and Subglottic Stenosis: A Case Report
Chalermchai Chintrakarn, MD*, Mana Rochanawuthanon, MD**
Affiliation : * Department of Otorhinolaryngology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University ** Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University
An 18 year-old woman presented with massive cervical lymphadenopathy. She also had bilateral
parotid gland enlargement, and later upper airway obstruction from subglottic mass compression. Surgical
excision of lymph nodes and bilateral total parotidectomy with facial nerve preservation were selected.
Direct laryngoscopy and CO2 laser excision were used to remove the subglottic mass. Airway was
secured by tracheostomy and after that it was removed. Histologic finding was Sinus histiocytosis with
massive lymphadenopathy (SHML) that involved the subglottic. SHML is very rare, probably less than 1000
cases reported in the literature and this is the 6th case in the literature that involved the subglottic. There are
no standard treatment modalities. The treatment is comprised of surgery, steroid, chemotherapy and local
control. In the present case the authors chose surgery, steroid and local control of disease in the subglottic
by using CO2 laser excision. Now, the disease is under control.
Keywords : Sinus histiocytosis, Subglottic stenosis, Laser surgery
