Laryngeal cancer pathophysiology

	Laryngeal cancer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Laryngeal cancer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Laryngeal cancer pathophysiology On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Laryngeal cancer pathophysiology All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Laryngeal cancer pathophysiology
CDC on Laryngeal cancer pathophysiology
Laryngeal cancer pathophysiology in the news
Blogs on Laryngeal cancer pathophysiology
Directions to Hospitals Treating Laryngeal cancer
Risk calculators and risk factors for Laryngeal cancer pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Laryngeal cancer arises from squamous cells, which are cells that are normally involved in protection of upper respiratory airways. Genes involved in the pathogenesis of laryngeal cancer include p16, NOTCH1, cyclin D1, and TP53. On gross pathology, flattened plaques, mucosal ulceration, and raised margins of the lesion are characteristic findings of laryngeal cancer. On microscopic histopathological analysis, spindle cells, basaloid cells, and nuclear atypia are characteristic findings of laryngeal cancer.

Pathophysiology

Laryngeal cancer arises from squamous cells, which are cells that are normally involved in protection of upper respiratory airways.

Genetics

Development of laryngeal cancer is the result of multiple genetic mutations. These mutations lead to activation of oncogenes and inactivation of tumor suppression genes which ultimately result in deregulated cellular proliferation. Genes involved in the pathogenesis of laryngeal cancer include:

Gross Pathology

On gross pathology, laryngeal cancer is characterized by:

Flattened plaques
Raised margins of the lesion
Mucosal ulceration

Gross pathology specimen of laryngeal cancer^[1]

Microscopic Pathology

On microscopic histopathological analysis, laryngeal carcinoma is characterized by:^[2]

Spindle cells
Basaloid cells
Nuclear atypia
Abundant chromatin

Squamous cell carcinoma is subdivided histopathologically by the World Health Organization into:^[2]

Keratinizing type:
- Keratinization & intercellular bridges through-out most of the malignant lesion
Undifferentiated type:
- Non-distinct borders/syncytial pattern
- Nucleoli
Non keratinizing type:
- Well-defined cell borders
- Eosinophilia
- Extra large nuclei/bizarre nuclei
- Inflammation (lymphocytes, plasma cells)
- Long rete ridges
- Numerous beeds/blobs of epithelial cells that seem unlikely to be rete ridges

Squamous Cell Carcinoma Subtypes

There are several histological subtypes of squamous cell carcinoma of larynx which include:^[2]

Basaloid
Warty (condylomatous)
Verrucous
Papillary
Lymphoepithelial
Spindle cell

Laryngeal squamous carcinoma (intermediate magnification)^[3]
Laryngeal squamous carcinoma (high magnification)^[3]
Laryngeal squamous carcinoma (very high magnification)^[3]

Immunohistochemistry

There are several immunohistochemistry markers of laryngeal carcinoma which include:

p63 positive
EBER negative
p16 negative
BCL2 positive/negative^[4]

References

↑ Media in category Laryngeal cancer. Wikimedia Commons 2015. https://commons.wikimedia.org/wiki/Category:Laryngeal_cancer. Accessed on October 29, 2015
↑ ^2.0 ^2.1 ^2.2 Protocol applies to all invasive carcinomas of the larynx, including supraglottis, glottis, and subglottis.http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Larynx_11protocol.pdf. Accessed on: October 28, 2015.
↑ ^3.0 ^3.1 ^3.2 Head and neck SCC Librepathology. http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_head_and_neck Accessed on October 26, 2015
↑ Nichols AC, Finkelstein DM, Faquin WC; et al. (2010). "Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer". Clin. Cancer Res. 16 (7): 2138–46. doi:10.1158/1078-0432.CCR-09-3185. PMID 20233885. Unknown parameter |month= ignored (help)

Template:WikiDoc Sources

[GrossLC1-1] Media in category Laryngeal cancer. Wikimedia Commons 2015. https://commons.wikimedia.org/wiki/Category:Laryngeal_cancer. Accessed on October 29, 2015

[abc-2] 2.0 ^2.1 ^2.2 Protocol applies to all invasive carcinomas of the larynx, including supraglottis, glottis, and subglottis.http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/Larynx_11protocol.pdf. Accessed on: October 28, 2015.

[aaa-3] 3.0 ^3.1 ^3.2 Head and neck SCC Librepathology. http://librepathology.org/wiki/index.php/Squamous_cell_carcinoma_of_the_head_and_neck Accessed on October 26, 2015

[pmid20233885-4] Nichols AC, Finkelstein DM, Faquin WC; et al. (2010). "Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer". Clin. Cancer Res. 16 (7): 2138–46. doi:10.1158/1078-0432.CCR-09-3185. PMID 20233885. Unknown parameter |month= ignored (help)

[1]

[2]

[3]

[4]