1 of 6
This immunocompromised patient is receiving monthly immunoglobulin infusions and has experienced many months of severe hoarseness. From a distance, one sees what looks like scarring or extra tissue mostly posteriorly.
2 of 6
Under narrow band light and at closer range, notice the vascular stippling. The initial impression was that this might be a fungal infection such as blastomycosis.
3 of 6
A month later, due to delay while optimizing her medical condition for brief general anesthesia, the abnormalities seem to have progressed/enlarged. Voice is even worse, and now the patient has mild symptoms of airway restriction.
5 of 6
Six weeks later, airway remains excellent; voice has re-deteriorated due to this inflammatory “polyp.”