Department of Pathology, Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Pathology and Laboratory Medicine, Emory University School of Medicine, 550 Peachtree St. NE Davis Fischer Bldg, Suite #1314A, Atlanta, GA, 30308, USA.
Head Neck Pathol. 2024 Aug 23;18(1):81. doi: 10.1007/s12105-024-01691-w.
Tyrosine-rich or tyrosine-like crystalloids (TC) were initially described in salivary gland pleomorphic adenoma. The presence of TC in non-neoplastic tissues is rare, and it has been reported exclusively in the larynx. This study aims to characterize the frequency and anatomical localization of TC in total laryngectomy specimens.
Review of consecutive laryngectomy specimens in which the cassette summary documented parasagittal section sampling of the right and left vocal folds and the anterior commissure. Data collected included patient demographics, underlying diagnoses, history of radiation therapy, presence, and location of TC.
Of 86 laryngectomy specimens, 16 (19%) contained amphophilic to eosinophilic TC. The study cohort included 11 males and 5 females, aged 37 to 85 years (mean 62, median 63). Laryngectomy surgery was performed for advanced untreated squamous cell carcinoma (SCCa) (7/16, 43.75%), recurrent post-treatment SCCa (7/16, 43.75%), previously untreated laryngeal large cell neuroendocrine carcinoma (1/16, 6.25%), and non-functional larynx post-chemoradiation (1/16, 6.25%). According to the macroscopic cassette summary, TC were predominantly found in the anterior commissure Sect. (13/16, 81.25%), with fewer cases in sections containing the left (2/16, 12.5%) or the right (1/16, 6.25%) vocal folds. Microscopically, TC localized to the anterior macula flava and/or adjacent vocal ligament (12/16, 75%) and the anterior commissure tendon (4/16, 25%).
TCs are predominantly reported as admixed with a neoplasm, however this study confirms that TC can also occur in non-neoplastic tissues of the larynx. There was no clear relationship between the presence of TC and prior radiation therapy. TC in the specialized connective tissues of the macula flava and true cord tendinous insertions distinct from tumor may form in response to alterations in mechanical stress, though an age-related change within the spectrum of normal laryngeal microanatomy also remains a possibility.
富含酪氨酸或酪氨酸样的结晶物质（TC）最初在唾液腺多形性腺瘤中被描述。TC 在非肿瘤组织中很少见，仅在喉部有报道。本研究旨在描述喉全切除标本中 TC 的频率和解剖定位。
回顾性分析连续的喉全切除标本，其中卡带总结记录了右和左声带以及前连合的矢状位切片取样。收集的数据包括患者的人口统计学资料、基础诊断、放射治疗史、TC 的存在和位置。
在 86 例喉全切除标本中，有 16 例（19%）含有嗜酸性至嗜碱性 TC。研究队列包括 11 名男性和 5 名女性，年龄 37 至 85 岁（平均 62 岁，中位数 63 岁）。喉全切除术是为治疗晚期未经治疗的鳞状细胞癌（SCCa）（7/16，43.75%）、治疗后复发的 SCCa（7/16，43.75%）、未经治疗的喉大细胞神经内分泌癌（1/16，6.25%）和化疗后无功能的喉（1/16，6.25%）而进行的。根据大体卡带总结，TC 主要在前连合节中发现（13/16，81.25%），在包含左侧（2/16，12.5%）或右侧（1/16，6.25%）声带的切片中发现的病例较少。镜下，TC 定位于前黄斑点和/或相邻的声带韧带（12/16，75%）和前连合腱（4/16，25%）。
TC 主要作为与肿瘤混合存在而被报道，然而本研究证实 TC 也可以发生在喉部的非肿瘤组织中。TC 的存在与放射治疗之间似乎没有明确的关系。在黄斑点和真声带腱膜的特化结缔组织中，与肿瘤不同的 TC 可能是由于机械应力改变而形成的，尽管这也可能是正常喉部微观解剖范围内的一种与年龄相关的变化。
