Wallis Lesly, Jackson-Menaldi Cristina, Holland Wayne, Giraldo Alvaro
Department of Pathology, St. John Hospital and Medical Center, Detroit, Michigan, USA.
J Voice. 2004 Mar;18(1):125-9. doi: 10.1016/j.jvoice.2003.07.003.
Vocal fold polyps and nodules are caused by inflammation caused by stress or irritation. Our study involved looking retrospectively at 30 patients. A clinical diagnosis was established by an otolaryngologist and voice pathologist through videostroboscopic analysis. Histological sections after removal of the vocal fold lesion were available for microscopic examination. All of these cases have also been previously evaluated and photographed. A clinical diagnosis of either a polyp or a laryngeal nodule have been made and documented. Two pathologists made the histological evaluation separately initially unaware of the clinical diagnosis. Their impression was recorded. After the clinical diagnosis become available and comparison between the clinical and pathological diagnosis were made, a retrospective review of the tissue was attempted to reconcile the differences. In conclusion, after careful histological evaluation, no definitive histological distinction can be made between laryngeal nodules and polyps. Our data showed no distinction between the two entities when compared for the presence of edema, fibrin, inflammation, and amyloid-like material. A statistically significant difference was found in the size of the specimen and the presence of telangiectasias. Based on our data, a biopsy larger than 0.3 cm could be a polyp and a biopsy less than 0.3 cm could be a nodule.
声带息肉和小结是由压力或刺激引起的炎症所致。我们的研究回顾性地观察了30例患者。由耳鼻喉科医生和嗓音病理学家通过频闪喉镜分析做出临床诊断。切除声带病变后的组织切片可供显微镜检查。所有这些病例之前也都经过了评估和拍照。已做出并记录了息肉或喉小结的临床诊断。两名病理学家最初在不知道临床诊断的情况下分别进行组织学评估。记录下他们的诊断意见。在获得临床诊断并对临床诊断和病理诊断进行比较后，试图对组织进行回顾性检查以协调差异。总之，经过仔细的组织学评估，喉小结和息肉之间无法做出明确的组织学区分。我们的数据显示，在比较水肿、纤维蛋白、炎症和淀粉样物质的存在情况时，这两种病变之间没有区别。在标本大小和毛细血管扩张的存在方面发现了统计学上的显著差异。根据我们的数据，大于0.3 cm的活检组织可能是息肉，小于0.3 cm的活检组织可能是小结。
