Laryngeal papilloma cells in culture have an altered cytoskeleton

We have investigated the effect of human papillomavirus (HPV) transformation on cellular cytoarchitecture. Cells from laryngeal papillomas and normal epithelium were cultured in vitro. Cytoskeletal components of both types of cells were visualized by immunofluorescence, to determine whether there were any differences in the structure or distribution of the cytoskeleton. There was no significant change in microtubules. Two major components of the cytoskeleton, the intermediate filaments and the microfilaments, were altered in the papilloma cells. Polyacrylamide gel electrophoresis of isolated keratins showed differences between normal and papilloma tissue, which might explain the altered intermediate filament distribution. The changes in cytoskeletal structure may be one way in which HPVs alter cellular growth controls.

Spindle-cell carcinoma of the upper aerodigestive tract mucosa. An immunohistologic and ultrastructural study of 18 biphasic tumors and comparison with seven monophasic spindle-cell tumors

The histogenetic origin of the spindle-cell component of spindle-cell carcinoma of the head and neck mucosa remains controversial. The spindle cells have been considered a variant growth pattern of squamous-cell carcinoma, a non-neoplastic mesenchymal reaction, and a malignant admixture of epithelial and mesenchymal neoplasm. To evaluate the spindle-cell component, we studied 25 tumors (18 biphasic and seven monophasic) by utilizing the following: an avidin-biotin complex immunoperoxidase technique with a variety of antikeratin antibodies (AE1, AE3, CAM 5.2, 35BH11, and polyclonal Dako) and a monoclonal antivimentin antibody, and an avidin-biotin alkaline phosphatase double-labeling technique to detect coexpression of keratin and vimentin. The immunohistologic staining pattern was compared with electron-microscopic studies. Eight of 18 biphasic neoplasms contained immunoreactive keratin in the spindle-cell component that was distributed focally in a minority of cells in 3 tumors and diffusely throughout five of the neoplasms. Four of seven ulcerated monophasic spindle-cell tumors devoid of histologic squamous-cell carcinoma also were keratin positive, confirming epithelial differentiation. The majority of the spindle cells in all the tumors contained vimentin intermediate filaments. In three immunoperoxidase keratin positive biphasic tumors examined with alkaline phosphatase double labeling, occasional spindle cells were found that coexpressed keratin and vimentin and were interspersed with cells expressing either intermediate filament. Electron microscopy was performed on the spindle-cell component of 13 tumors, nine biphasic and four monophasic. Of the biphasic tumors, four were immunoperoxidase keratin positive; three of these showed epithelial differentiation by electron microscopy. Five biphasic tumors were keratin negative, and three tumors had epithelial differentiation by electron microscopy. Four monophasic spindle-cell tumors were immunoperoxidase keratin positive, and one of these had epithelial features by electron microscopy. Two monophasic tumors were keratin negative and without ultrastructural evidence of epithelial features. By using a combination of immunohistochemical and electron-microscopic observations, we identified evidence for epithelial differentiation in the spindled cells in 11 of 18 biphasic tumors and four of seven monophasic spindle-cell tumors.

Apoptotic bodies and abnormally dividing epithelial cells in squamous cell carcinoma

Apoptotic bodies were investigated ultrastructurally in 10 cases of squamous cell carcinoma taken from buccal mucosa, tongue and larynx. Epithelial cells undergoing mitosis were found to show premature formation of nuclear membranes around various aggregates of chromosomal material giving the appearance of micronuclei. These cells were also shown to exhibit changes in their cytoplasm different from those seen in normally dividing epithelial cells. The changes seen in both the nuclei and cytoplasm of these cells were similar to those observed in cells undergoing apoptosis. It is suggested from this study that some apoptotic bodies, especially those of epithelial cell origin, may result from degeneration affecting cells in abnormal mitosis.

Tyrosine-rich crystalloids in neoplasms and tissues of the head and neck

Tyrosine-rich crystalloids were identified in three benign mixed tumors of the parotid gland, one terminal duct adenocarcinoma of a minor salivary gland, and the fibrous connective tissue of two laryngectomy specimens. Light and electron microscopic studies showed the crystalloids to be composed of irregular deposits of amorphous electron-dense material. In the salivary gland tumors this material was commonly associated with interstitial collagen and was found in greatest abundance near myoepithelial cells. This proximity suggests that the tyrosine-rich crystalloids result from the precipitation on stromal collagen of products secreted by neoplastic myoepithelial cells.

Neurilemmoma of the larynx: (a case report)

The authors have treated a 61-year-old woman with neurilemmoma of the larynx. The tumour was located in the submucosal region of the arytenoid on the right side of the larynx. Surgical resection of the tumour had to be done by external neck excision instead of endoscopically.

Mucociliary clearance and mucosal surface characteristics before and after total laryngectomy

Forty heavy smokers, all males aged between 40 and 70 and affected by laryngeal cancer underwent mucociliary clearance evaluation the day before total laryngectomy, 60 days after and, in 6 of them, 5 years later. Specimens of nasal and tracheal mucosa were obtained during laryngectomy and other subsequent operations. Before total laryngectomy, no significant changes in nasal mucociliary clearance were observed in smokers and controls, and the nasal ciliary carpet was fairly well preserved. Bronchial mucociliary clearance was impaired in all patients, owing to the coexistent chronic obstructive bronchitis. 60 days after the operation, nasal mucociliary clearance was significantly improved when compared with the preoperative data and controls, owing to the increase in the endonasal temperature and humidity, and to the reduction of the nasal blood flow and disappearance of the nasal cycle, which follow tracheostomy. Surface morphologic studies show a change in the squamous epithelium of the anterior third of the nasal fossa into a columnar ciliated one. During the first 3 months after the operation, tracheobronchial mucociliary clearance increased of 50% vis-à-vis the preoperative data. During this period a clinically evident bronchial hypersecretion was observed. The reduction in nasal and tracheobronchial mucociliary clearance function which became evident 6 years after the operation, is probably due to secondary chronic infections.

Biological studies of ten human squamous carcinoma cell lines: an overview

Ten cell lines established from surgical specimens of human squamous carcinomas of the tongue and larynx have been investigated with respect to their motility, ultrastructure, karyotypes, certain biochemical features, interaction with normal epithelial and stromal elements and capacity to infiltrate three-dimensional organoid systems. All the cell lines have maintained several morphological and biochemical characteristics indicating a common origin, although the extent to which each line displays this heritage is variable. The phenotypes of each of the individual cell lines are, however, notably stable. Data are provided for epithelial surface markers (including epidermal growth factor, EGF) and for the synthesis and release of prostaglandins and proteases which may be involved in invasive mechanisms. Encounters between the cell lines and organoid substrata (embryonic chick heart spheroids, human amnion, chick chorioallantoic membrane) are described: the results indicate a scale of invasiveness ranging from lack of penetration to full-thickness infiltration by cells showing various distinctive growth patterns. Correlation between in vitro and in vivo findings is discussed, and it is suggested that the biological heterogeneity of the lines may reflect inherent properties of the original carcinoma cell populations which are more distinctly expressed in vitro.

Mast cell sarcoma of the larynx

A 74 year old woman presented with a primary subglottic tumour. Neither cutaneous mastocytosis (urticaria pigmentosa) nor spread to the bone marrow, liver, or spleen were detected. About two years after initial manifestation of the tumour nodular skin metastases appeared, as well as local recurrence in the larynx. Despite chemotherapy and radiation the disease progressed and was fatal. The terminal phase was characterised by generalisation of the mast cell tumour with diffuse infiltration of bone marrow and, shortly before death, leukaemic transformation. The patient died four years after onset of disease with symptoms of a hemorrhagic diathesis. As far as we know this is the first case of mast cell sarcoma to be reported in man.

Oncocytic and oncocytoid carcinoid tumors (well-differentiated neuroendocrine carcinomas) of the larynx

Carcinoid tumors of the larynx are exceedingly rare neoplasms. With the inclusion of the five neoplasms we report herein, the total number reported in the English-language literature is 16. These five neoplasms all showed light microscopic features of oncocytic (or oncocytoid) cells. Ultrastructurally, all lesions contained dense-core granules of the neurosecretory type. One case further met the ultrastructural criteria for true oncocytoma (that is, an oncocytic carcinoid). The lesion did not metastasize, and the patient was successfully treated surgically. In the other four cases, the lesions were considered to be oncocytoid carcinoids, since they failed to meet the ultrastructural requirements of a true oncocytoma. Each of these four lesions metastasized, although one patient did have a long, indolent course.

Granular cell tumours of the oesophagus and larynx

Two cases of granular cell tumour of the oesophagus and one case of granular cell tumour of the larynx are reported. The light and electron microscope findings are discussed, as well as the much debated histogenesis of such tumours.

Canine laryngeal rhabdomyoma

Three canine laryngeal tumors were diagnosed as oncocytomas by light microscopy, but were determined to be rhabdomyomas following ultrastructural and immunocytochemical examination. Tumors consisted of large eosinophilic cells interspersed with smaller dark cells. Large tumor cells had a granular, intensely eosinophilic cytoplasm. Scattered through the tumors were a few elongated cells with cytoplasmic cross striations and multiple nuclei. Tumor cells from all three dogs contained numerous mitochondria and bundles of myofibrils with electron-dense Z-lines typical of striated muscle cells. Intracellular myoglobin and desmin were detected in the tumors by immunocytochemistry. Comparisons are made with a previous report of canine laryngeal oncocytomas.

Neuroendocrine carcinomas of the larynx. A study of two types, one of which mimics thyroid medullary carcinoma

We studied 13 neuroendocrine carcinomas of the larynx. They constituted 59% of the 22 nonepidermoid carcinomas of the larynx seen at Memorial Hospital during a 45-year period, and for which adequate material was available for review. Four tumors were histologically identical to small cell carcinomas of the lung and were classified as small cell neuroendocrine carcinomas (SCNC). One case represents one of the original descriptions of the laryngeal SCNC. No SCNC was argyrophil, and of the three studied immunohistochemically, all contained neuron-specific enolase, one carcinoembryonic antigen (CEA) and one serotonin. Nine tumors were large cell carcinomas (LCNC). Eight LCNC were argyrophil, and all nine contained neuron-specific enolase, six calcitonin, four CEA, one HCG, two serotonin, and two somatostatin. The laryngeal neuroendocrine carcinomas commonly presented in chronic cigarette smokers with mean ages of 63 (SCNC) and 60 (LCNC), were not associated with other endocrine tumors, and proved highly fatal in spite of radical surgery and radiation therapy. At last follow-up only one patient was alive (after 13 months). Patients dying with SCNC survived a mean of 11 months, and those with LCNC, 36 months. To determine whether the laryngeal LCNC most closely resembles pulmonary neuroendocrine tumors, head and neck paragangliomas, or thyroid medullary carcinoma (TMC), they were histologically, histochemically, and immunohistochemically compared with control cases of each group. Overall, LCNC most closely resembles TMC, and given the frequency with which each presents as a neck mass, misinterpretation of one for the other is very possible. Evidence is provided suggesting that some LCNC have also been mistaken for the laryngeal paraganglioma.

Canine laryngopharyngeal rhabdomyoma resembling an oncocytoma: light microscopic, ultrastructural and comparative studies

A laryngopharyngeal rhabdomyoma was diagnosed in a four-year-old dog with clinical signs of upper respiratory obstruction. In people, rhabdomyomas have a predilection for the head and neck area. Features of this tumor were compared with an oncocytoma with which it may be confused.

Laryngeal chondrosarcoma: gross pathological, histologic and electron microscopic characteristics

Chondrosarcoma is an uncommon cartilaginous tumour of the upper respiratory tract, and its morphology and clinical course vary widely. Few reports have evaluated the clinicopathological findings of this tumour in the larynx. This paper reports on a low-grade chondrosarcoma in a 44-year-old woman who required laryngectomy for cure. The gross pathological, histologic and electron microscopic features of the tumour are analysed with respect to its clinical course, using histopathological criteria.

Ultrastructural features of the interferon-treated adult laryngeal papilloma

The ultrastructural features of the interferon-treated adult laryngeal papillomas are described. Compared with untreated papillomas, no differences in ultrastructure were found by transmission electron microscopy. By scanning electron microscopy, significant alterations comprising a smooth and oedematous surface with a uniform microvilli pattern of the superficial cells were observed after interferon therapy. Our observations suggest an increased cell adhesion and maturation of epithelial cells caused by interferon.

Carcinoid of the larynx: a report of three cases and a review of the literature

Carcinoid tumors are among the exceptional neoplasms of the larynx. The laryngeal carcinoid was first described in 1969 by Goldman, et al. Only 16 cases could be traced from the literature. This paper describes three additional cases. In one patient, the tumor infiltrated the laryngeal tissues and metastasized to the cervical lymph nodes breast. In the second case, the polypoid lesion could be excised completely. The third case was initially diagnosed as undifferentiated squamous cell carcinoma. The diagnosis of carcinoid was made a few years later when a metastasis was removed. The presence of intracellular membrane bound neurosecretory granules and positive argyrophilia in the Grimelius stain are characteristic. In half of the cases described in the literature, the tumor was initially misdiagnosed as undifferentiated carcinoma. The treatment of choice is surgical removal which may be curative. The literature is reviewed.

Ultrastructural features of the adult laryngeal papilloma

The ultrastructural features of nine laryngeal papillomas of the adult type were examined by transmission and scanning electron microscopy. The surface was covered by numerous microvilli varying in size and shape and often arranged in parallel cords. Although we did not find virus-like particles, the ultrastructural characteristics of the adult type of laryngeal papilloma did not differ from those previously found on the juvenile type. The two types may in nature be one and the same lesion, differing in behaviour because of the different environments.

An immunohistochemical and electron-microscopic study of vascular endothelial cells in vocal fold polyps

Gelatinous and telangiectatic types can be differentiated among the human vocal fold polyps. Telangiectatic polyps are characterized by eosinophilic deposits consisting of fibrin and cellular blood constituents. Labyrinthine vascular channels are characteristic of these polyps, and are partially or completely lined by a single layer of flat cells. Using electron microscopy and immunohistochemical stainings (antibodies against factor VIII-related antigen, Ulex europaeus I lectin, and antibodies against lysozyme), we found that the lining cells are true vascular endothelial cells and are not organizing histiocytic cells that are arranged in an endothelial-like pattern.

The role of scanning electron microscopy in the diagnosis of human laryngeal cancer

Malignant and non-malignant human laryngeal tissue samples (31 cases) were examined first by light microscopy (LM) and then the specimens were reprocessed for scanning electron microscopy (SEM). The presence of LM and SEM signs of malignancy were compared with each other. In all the 22 histologically unambiguous cases the LM and SEM results were in accordance with each other. From the 9 histologically doubtful cases, 2 were found malignant and 3 benign by retrospective SEM. The case histories of these 5 patients have confirmed the SEM results. This preliminary study suggests the application of SEM in histologically doubtful laryngeal biopsies.

Laryngeal neuroendocrine tumour with features of a paraganglioma, intracytoplasmic lumina and acinar formation

A supraglottic laryngeal neuroendocrine tumour in a 71-year-old female is presented. In addition to the typical features of extra-adrenal paragangliomas it showed unusual, numerous intracytoplasmic lumina and occasional true acini with accumulation of alcian blue and PAS positive secretory product in them which led originally to an erroneous diagnosis of metastatic adenocarcinoma. Ultrastructurally, the tumour was composed of light and dark chief cells containing varying numbers of dense-core secretory granules. Intracytoplasmic lumina and true acini contained microvilli with glycocalyceal material and varying amounts of membranous and amorphous material, possibly secreted via small, smooth-surfaced cytoplasmic vesicles but typical mucin granules were not seen. These features have not been previously described in laryngeal paragangliomas but are seen in endocrine tumours of other sites and have been used as an argument in favour of an endodermal rather than ectodermal origin for endocrine cells in those sites. Laryngeal paragangliomas are often malignant and the presence of spasmodic pain appears to be the most reliable indication of possible malignancy, histological criteria being as yet poorly defined.

Tubuloreticular structures in laryngeal carcinoma

Tubuloreticular structures (TRS) were observed electron microscopically in stroma cells of human laryngeal carcinoma. The TRS appeared as networks of membranous tubules 20-30 nm in diameter, which were always situated in dilations of the endoplasmic reticulum (ER). The presence of TRS was observed not only in cells situated in the tumour stroma, but also in some stroma cells which had migrated to the carcinomatous epithelium. However, they were not found in malignant keratinocytes. In some places, incomplete forms of TRS may be observed, which in earlier reports have been referred to as worm-like or comma-shaped bodies. These incomplete forms of TRS, which are clearly shown to arise contiguous to the ER cisternae, may represent different developmental stages of TRS morphogenesis rather than disintegration steps. The observations indicate that the TRS - seen in various disorders such as viral, neoplastic, and auto-immune diseases - may well represent a common reaction pattern of the ER system of the host cell.