Differential diagnosis of laryngeal cancer

Laryngeal cancer needs to be differentiated from the following diseases:

(1) Laryngeal tuberculosis. The main symptoms of laryngeal tuberculosis are hoarseness and sore throat, which often interfere with eating. Laryngoscopy shows pale and edematous laryngeal mucosa, with shallow ulcers on the surface, covered with purulent secretions. The lesions are mostly located in the back of the larynx, the movement of the vocal cords is not affected, and there is rarely any difficulty breathing. Chest X-ray examination, tuberculosis in sputum and laryngeal biopsy can provide important basis for differential diagnosis, but attention should be paid to the possibility of laryngeal cancer and laryngeal tuberculosis coexisting.

(2) Laryngeal papilloma. Laryngeal papilloma occurring in middle-aged and older patients should be differentiated from laryngeal cancer. Patients with papilloma have a long medical history and often have single or multiple papilloma, with or without a pedicle at the base. Patients without a pedicle at the base should be differentiated from laryngeal cancer. However, papilloma lesions are located on the mucosal surface. Even if the range is wide, there is no vocal cord movement disorder. Some parts of the papilloma become cancerous while other parts still retain the characteristics of papilloma. Laryngeal cancer is usually single, involving the vocal cords early and causing hoarseness.

(3) Laryngeal keratosis. The main symptom of this disease is hoarseness. The disease lasts for a long time and progresses slowly. It is generally considered to be a precursor of laryngeal cancer. Laryngoscopy can reveal flat or warty white patches in the larynx. The diagnosis of this disease depends on multiple biopsies and long-term close follow-up.

(4) Laryngeal polyps. It is not difficult to differentiate typical laryngeal polyps from laryngeal cancer. Sometimes some hemorrhagic polyps are easily misdiagnosed. Suspicious polyp tissues should be removed and sent for pathological examination.

(5) Contact ulcer. Sometimes this disease is easily misdiagnosed as ulcerative cancer. Contact ulcers often occur at the vocal cord process behind the posterior cingulate, with a long course of disease. The lesions are localized and do not expand. Biopsy shows necrotic tissue.

(6) Laryngeal prolapse or laryngeal air cyst. This disease can be confused with laryngeal cancer. The surface of laryngeal prolapse and laryngeal air cyst is smooth and without ulcers. X-rays can show air-filled cavities.

(7) Vocal cord paralysis. For unexplained vocal cord paralysis, the possibility of subglottic cancer should be considered and should be checked and ruled out.

(8) Laryngeal amyloid tumor. It is a benign inflammatory tumor that can interfere with vocal cord movement and cause laryngeal obstruction. Its surface is smooth and difficult to distinguish from cancer. It is hard in texture and can be diagnosed by biopsy.

(9) Laryngeal chondroma. This disease is extremely rare and usually occurs on the inner surface of the cricoid cartilage. It is rare to occur on the thyroid cartilage, and rarely on the arytenoid cartilage. The main manifestation is dyspnea. The mucosal surface is smooth and hard in texture. Biopsy can confirm the diagnosis.