Juvenile laryngeal papilloma: histologic and photometric evaluation of atypia.

Juvenile papillomas are the most common proliferative laryngeal lesion in children. Atypia may be present but is difficult to interpret owing to the basically benign character of the lesion. A histologic and clinical classification of 23 cases of juvenile laryngeal papillomas was performed following the criteria suggested by Quick and co-workers in 1979 and intended to enable the clinical course to be more accurately predicted. The various histologic types of papillomas were characterized by single-cell microdensitometry. The photometric study verified the increase in the relative width of the proliferative zone with the degree of atypia. Severe atypia was the only histologic type associated with hypertetraploid nuclei. The frequent occurrence of mild atypia was unrelated to the clinical course. The moderate and severe degrees of atypia were more common during periods of relatively frequent operations. Severe atypia was rare but in one patient it heralded the development of invasive carcinoma.