A patient with an autoimmune disease may develop one or more nodules on the vocal fold termed a "bamboo nodule".
Pathogenesis: The lesion may result secondary to deposition of high molecular weight immune complexes in small blood vessels in the vocal folds. These deposits elicit a secondary inflammatory response with hyaline degeneration.
Clinical features:
(1) dysphonia, intermittent aphonia or hoarseness
(2) history or evidence of an autoimmune disease (SLE, Sjogren's syndrome, RA, etc)
(3) transverse whitish or yellowish submucosal deposit in the middle third of one or both vocal folds that resemble a bamboo node or joint
A biopsy shows histologic features resembling a rheumatoid nodule with hyaline degeneration, submucosal edema and chronic inflammatory cell infiltrate.
Differential diagnosis:
(1) other nodules or tumors of the vocal cord
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