Laryngeal cancer pathophysiology

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Laryngeal cancer arises from squamous cells, which are cells that are normally involved in protection of upper respiratory airways. Genes involved in the pathogenesis of laryngeal cancer include p16, NOTCH1, cyclin D1, and TP53. On gross pathology, flattened plaques, mucosal ulceration, and raised margins of the lesion are characteristic findings of laryngeal cancer. On microscopic histopathological analysis, spindle cells, basaloid cells, and nuclear atypia are characteristic findings of laryngeal cancer.

Pathophysiology

Laryngeal cancer arises from squamous cells, which are cells that are normally involved in protection of upper respiratory airways.

Genetics

Development of laryngeal cancer is the result of multiple genetic mutations. These mutations lead to activation of oncogenes and inactivation of tumor suppression genes which ultimately result in deregulated cellular proliferation. Genes involved in the pathogenesis of laryngeal cancer include:

Gross Pathology

On gross pathology, laryngeal cancer is characterized by:

Flattened plaques
Raised margins of the lesion
Mucosal ulceration

Gross pathology specimen of laryngeal cancer^[1]

Microscopic Pathology

On microscopic histopathological analysis, laryngeal carcinoma is characterized by:

Spindle cells
Basaloid cells
Nuclear atypia
Abundant chromatin

Squamous cell carcinoma is subdivided histopathologically by the World Health Organization into:

Keratinizing type:
- Keratinization & intercellular bridges through-out most of the malignant lesion
Undifferentiated type:
- Non-distinct borders/syncytial pattern
- Nucleoli
Non keratinizing type:
- Well-defined cell borders
- Eosinophilia
- Extra large nuclei/bizarre nuclei
- Inflammation (lymphocytes, plasma cells)
- Long rete ridges
- Numerous beeds/blobs of epithelial cells that seem unlikely to be rete ridges

Squamous Cell Carcinoma Subtypes

There are several histological subtypes of squamous cell carcinoma of larynx which include:^[2]

Basaloid
Warty (condylomatous)
Verrucous
Papillary
Lymphoepithelial
Spindle cell

Laryngeal squamous carcinoma (intermediate magnification)^[3]
Laryngeal squamous carcinoma (high magnification)^[3]
Laryngeal squamous carcinoma (very high magnification)^[3]

Immunohistochemistry

There are several immunohistochemistry markers of laryngeal carcinoma which include:

p63 positive
EBER negative
p16 negative
BCL2 positive/negative^[4]

References

↑ Media in category Laryngeal cancer. Wikimedia Commons 2015. https://commons.wikimedia.org/wiki/Category:Laryngeal_cancer. Accessed on October 29, 2015
↑ Deitmer T (February 1983). "[Pathogenesis of laryngeal cancer in women. A clinical and follow-up study]". Laryngol Rhinol Otol (Stuttg) (in German). 62 (2): 68–73. PMID 6843235.
↑ ^3.0 ^3.1 ^3.2 Head and neck SCC Librepathology. http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_head_and_neck Accessed on October 26, 2015
↑ Nichols AC, Finkelstein DM, Faquin WC; et al. (2010). "Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer". Clin. Cancer Res. 16 (7): 2138–46. doi:10.1158/1078-0432.CCR-09-3185. PMID 20233885. Unknown parameter |month= ignored (help)

Template:WikiDoc Sources

[GrossLC1-1] Media in category Laryngeal cancer. Wikimedia Commons 2015. https://commons.wikimedia.org/wiki/Category:Laryngeal_cancer. Accessed on October 29, 2015

[pmid6843235-2] Deitmer T (February 1983). "[Pathogenesis of laryngeal cancer in women. A clinical and follow-up study]". Laryngol Rhinol Otol (Stuttg) (in German). 62 (2): 68–73. PMID 6843235.

[aaa-3] 3.0 ^3.1 ^3.2 Head and neck SCC Librepathology. http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_head_and_neck Accessed on October 26, 2015

[pmid20233885-4] Nichols AC, Finkelstein DM, Faquin WC; et al. (2010). "Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer". Clin. Cancer Res. 16 (7): 2138–46. doi:10.1158/1078-0432.CCR-09-3185. PMID 20233885. Unknown parameter |month= ignored (help)

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