Differential Diagnosis for a 44-year-old Male with a 15 Pack Year Smoking History and Hoarse Voice
- Single Most Likely Diagnosis
- Chronic Laryngitis: This condition is often associated with smoking and can cause inflammation of the larynx, leading to a hoarse voice. The patient's significant smoking history supports this diagnosis.
- Other Likely Diagnoses
- Vocal Cord Polyps or Nodules: These growths can develop from voice abuse or misuse and are more common in smokers. They can cause hoarseness by altering the vocal cord's ability to vibrate normally.
- Gastroesophageal Reflux Disease (GERD): GERD can lead to laryngopharyngeal reflux, causing stomach acid to flow up into the throat and irritate the vocal cords, resulting in hoarseness.
- Thyroid Disease: Conditions like hypothyroidism can affect the voice, although this is less directly related to smoking history.
- Do Not Miss Diagnoses
- Laryngeal Cancer: Although less common, laryngeal cancer is a critical diagnosis to consider, especially given the patient's smoking history, which significantly increases the risk of this disease.
- Lung Cancer with Recurrent Laryngeal Nerve Involvement: Lung cancer can metastasize or directly invade the recurrent laryngeal nerve, leading to hoarseness. This is a potentially life-threatening condition that must be ruled out.
- Rare Diagnoses
- Amyloidosis: A condition characterized by the deposition of amyloid proteins in various tissues, including the larynx, which can cause hoarseness.
- Sarcoidosis: An autoimmune disease that can affect multiple parts of the body, including the larynx, leading to hoarseness.
- Relapsing Polychondritis: A rare autoimmune disorder that can cause inflammation of the cartilages of the body, including those in the larynx, potentially leading to hoarseness.