Laryngeal cancer pathophysiology

Laryngeal cancer Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Laryngeal cancer from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Laryngeal cancer pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Laryngeal cancer pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Laryngeal cancer pathophysiology

CDC on Laryngeal cancer pathophysiology

Laryngeal cancer pathophysiology in the news

Blogs on Laryngeal cancer pathophysiology

Directions to Hospitals Treating Laryngeal cancer

Risk calculators and risk factors for Laryngeal cancer pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Omer Kamal, M.D.[2], Faizan Sheraz, M.D. [3]

## Overview

[edit | edit source]

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

[edit | edit source]

Laryngeal cancer arises from squamous cells, which are cells that are normally involved in protection of upper respiratory airways.[1]

### Genetics

[edit | edit source]

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]

* p16
* NOTCH1
* Cyclin D1
* TP53

### Gross Pathology

[edit | edit source]

On gross pathology, laryngeal cancer is characterized by:[3][4]

* Flattened plaques
* Raised margins of the lesion
* Mucosal ulceration

### Microscopic Pathology

[edit | edit source]

On microscopic histopathological analysis, laryngeal carcinoma is characterized by:[5][6][7][8]

* Spindle cells
* Basaloid cells
* Nuclear atypia
* Abundant chromatin

Squamous cell carcinoma is subdivided histopathologically:[5][6][9]

* 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

[edit | edit source]

There are several immunohistochemistry markers of laryngeal carcinoma which include:[10][11]

* p63 positive
* EBER negative
* p16 negative
* BCL2 positive/negative

## References

[edit | edit source]

1. ↑ Koufman JA, Burke AJ (February 1997). "The etiology and pathogenesis of laryngeal carcinoma". Otolaryngol. Clin. North Am. 30 (1): 1–19. PMID 8995133.
2. ↑ 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. ↑ Sessions DG (June 1976). "Surgical pathology of cancer of the larynx and hypopharynx". Laryngoscope. 86 (6): 814–39. doi:10.1288/00005537-197606000-00009. PMID 933673.
4. ↑ "journals.sagepub.com".
5. ↑ 5.0 5.1 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.
6. ↑ 6.0 6.1 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.
7. ↑ MUSTAKALLIO S (August 1946). "Relation of microscopic structure of laryngeal cancer to radiocurability". Acta radiol. 27 (5): 473–80. PMID 20286025.
8. ↑ Franz B, Wetzel M (July 1980). "[Cytology of the early invasive laryngeal cancer (author's transl)]". Laryngol Rhinol Otol (Stuttg) (in German). 59 (7): 401–5. PMID 7453440.CS1 maint: Unrecognized language (link)
9. ↑ Lewis JS (March 2011). "Not your usual cancer case: variants of laryngeal squamous cell carcinoma". Head Neck Pathol. 5 (1): 23–30. doi:10.1007/s12105-010-0232-0. PMC 3037456. PMID 21165725.
10. ↑ Rodrigo JP, Martínez P, Allonca E, Alonso-Durán L, Suárez C, Astudillo A, García-Pedrero JM (March 2014). "Immunohistochemical markers of distant metastasis in laryngeal and hypopharyngeal squamous cell carcinomas". Clin. Exp. Metastasis. 31 (3): 317–25. doi:10.1007/s10585-013-9630-5. PMID 24370715.
11. ↑ Wittekindt C, Sittel C, Kvasnicka HM, Eckel HE (August 2006). "Immunohistochemistry of whole-organ sections of advanced human laryngeal cancer". Eur Arch Otorhinolaryngol. 263 (8): 741–6. doi:10.1007/s00405-006-0055-5. PMID 16683119.

Template:WikiDoc Sources