The Kambic-Gale method of assessment of epithelial hyperplastic lesions of the larynx in comparison with the dysplasia grade method.

Sections of vocal cord biopsies from 47 cases in whom had been previously assessed by a dysplasia grading system at from I to III, were reclassified according to the Ljubljana system. The majority of the Grade I lesions were reclassified as "non-risky", but a small number were put into the risky or even carcinoma in situ groups. While most of the Grade III cases were reclassified as "risky" there were a few who were assigned to a non-risky category. It is suggested that with the Ljubljana histological grading system a more clear-cut separation of cases with risk of developing vocal cord malignancy from those with no such risk, is possible. Attention is drawn to a lesion denoted as "large cell hyperplasia", which is not covered in the grading or Ljubljana categorization of vocal cord lesions. The malpighian cells in this lesion are enlarged to over 30 microm in diameter, and show prominent nucleoli: apoptotic cells are prominent. Evidence is presented that this may be a categorical risk for the development of malignant changes.