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.[1]
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:[2]
Gross Pathology
On gross pathology, laryngeal cancer is characterized by:
- Flattened plaques
- Raised margins of the lesion
- Mucosal ulceration
Microscopic Pathology
On microscopic histopathological analysis, laryngeal carcinoma is characterized by:[3][4][5]
- Spindle cells
- Basaloid cells
- Nuclear atypia
- Abundant chromatin
Squamous cell carcinoma is subdivided histopathologically by the World Health Organization into:[3][4]
- 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:
- Basaloid
- Warty (condylomatous)
- Verrucous
- Papillary
- Lymphoepithelial
- Spindle cell
Immunohistochemistry
There are several immunohistochemistry markers of laryngeal carcinoma which include:
- p63 positive
- EBER negative
- p16 negative
- BCL2 positive/negative
References
- ↑ Koufman JA, Burke AJ (February 1997). "The etiology and pathogenesis of laryngeal carcinoma". Otolaryngol. Clin. North Am. 30 (1): 1–19. PMID 8995133.
- ↑ de Miguel-Luken MJ, Chaves-Conde M, Carnero A (May 2016). "A genetic view of laryngeal cancer heterogeneity". Cell Cycle. 15 (9): 1202–12. doi:10.1080/15384101.2016.1156275. PMC 4894505. PMID 26940775.
- ↑ 3.0 3.1 Hilly O, Raz R, Vaisbuch Y, Strenov Y, Segal K, Koren R, Shvero J (November 2012). "Thyroid gland involvement in advanced laryngeal cancer: association with clinical and pathologic characteristics". Head Neck. 34 (11): 1586–90. doi:10.1002/hed.21972. PMID 22180291.
- ↑ 4.0 4.1 Caldas-Magalhaes J, Kasperts N, Kooij N, van den Berg CA, Terhaard CH, Raaijmakers CP, Philippens ME (February 2012). "Validation of imaging with pathology in laryngeal cancer: accuracy of the registration methodology". Int. J. Radiat. Oncol. Biol. Phys. 82 (2): e289–98. doi:10.1016/j.ijrobp.2011.05.004. PMID 21719209.
- ↑ MUSTAKALLIO S (August 1946). "Relation of microscopic structure of laryngeal cancer to radiocurability". Acta radiol. 27 (5): 473–80. PMID 20286025.