Frequency and significance of epithelial atypia in laryngeal papillomatosis.

The clinical records and microscopic sections from 32 patients were reviewed in an attempt to correlate histopathologic features with clinical behavior. Three general clinical groups were identified on the basis of recurrence rates and extent of papillomatosis. In those lesions with the highest frequency of recurrences, epithelial atypia tended to be most pronounced. Although some of the lesions were quite disturbing, there was no evidence of invasive carcinoma. It remains unknown to date whether these cytologic abnormalities represent a neoplastic alteration or possibly atypia on the basis of rapid, but benign, cellular turnover. Further studies at our center and other institutions are necessary to test the proposed classification which, if validated, would provide a means of predicting the course of the disease and efficacy of the chosen management in these difficult cases.