Vocal cord nodule/polyp

Vocal cord nodule/polyp, also known as singer’s nodules, is a non-neoplastic lesion secondary to inflammation or trauma to the true vocal cord.  There are four histologic subtypes: edematous-myxoid, fibrous, vascular, and hyaline.  However, most polyps show overlap of these features as seen in the photomicrograph, which demonstrate vascular-hyaline as well as edematous-myxoid composition.

Vocal cord polyps/nodules commonly occur with chronic voice abuse, but can also occur with alcohol and tobacco use, hypothyroidism, and laryngitis. With chronic irritation, the true vocal cord along with the Reinke’s layer becomes fibrotic. The extravasation of fluids from thin-walled vessels results in polyp formation. Both nodules and polyps have similar histology and clinical symptoms. Most nodules and polyps occur in the middle third of the true vocal cord. Patients typically present with hoarseness or dysphonia. Differential diagnosis includes myxoma (i.e., secondary to hypothyroidism) and amyloidosis. Treatment is voice therapy for nodules and surgical resection for polyps.