Ferlito A, Devaney K O, Rinaldo A
Department of Otolaryngology, University of Padua, Italy.
Ann Otol Rhinol Laryngol. 1996 Nov;105(11):926-32. doi: 10.1177/000348949610501115.
Both otolaryngologists and surgical pathologists are involved in the diagnosis and treatment of lesions of the larynx that are best diagnosed as invasive squamous cell carcinomas of some specified degree of differentiation, not further subclassified (that is, conventional squamous cell carcinomas). On occasion, however, a patient will present with an invasive tumor that on histologic examination diverges from the expected pattern of a squamous cell carcinoma of the usual type and so raises the question of proper classification (on the part of the pathologist) and, following classification, a consideration of the prognostic and therapeutic implications of such a classification (on the part of the clinician). While some of these unconventional squamous cell carcinomas are rather indolent lesions (as, for example, the hybrid verrucous squamous cell carcinoma), others behave in a fashion similar to conventional squamous cell carcinomas (such as the adenoid squamous cell carcinomas), and yet others seem to behave more aggressively than do conventional squamous cell carcinomas of a similar size and stage (examples include the basaloid squamous cell carcinomas and adenosquamous carcinomas). Finally, the possibility exists within the larynx, as elsewhere in the body, that a nonepithelial lesion such as malignant melanoma may mimic a tumor more commonly encountered in that vicinity- namely, a squamous cell carcinoma- and so receive inappropriate treatment if such mimicry is not recognized.
耳鼻喉科医生和外科病理学家都参与喉病变的诊断和治疗，这些病变最好诊断为具有一定分化程度的浸润性鳞状细胞癌，不再进一步细分（即传统鳞状细胞癌）。然而，有时患者会出现浸润性肿瘤，经组织学检查发现其与常见类型鳞状细胞癌的预期模式不同，从而引发了（病理学家方面的）正确分类问题，以及分类后（临床医生方面）对这种分类的预后和治疗意义的考量。虽然其中一些非传统鳞状细胞癌是相对惰性的病变（例如，混合性疣状鳞状细胞癌），其他一些表现类似于传统鳞状细胞癌（如腺样鳞状细胞癌），还有一些似乎比大小和分期相似的传统鳞状细胞癌表现得更具侵袭性（例如基底样鳞状细胞癌和腺鳞癌）。最后，与身体其他部位一样，喉内存在非上皮性病变（如恶性黑色素瘤）可能模仿该区域更常见的肿瘤——即鳞状细胞癌——的可能性，如果这种模仿未被识别，就可能接受不恰当的治疗。
