Vocal Polyps: Clinical, Morphological, and Immunohistochemical Aspects
Accepted 5 May 2009. published online 25 January 2010. Corrected Proof
Summary
Objectives
To study the clinical, morphological, and immunohistochemical characteristics of vocal polyps.
Study Design
Prospective and retrospective.
Methods
Clinical study: 76 medical charts from patients with polyps were reviewed. Histology study: in 42 slides from surgical specimens, the following were analyzed: epithelium, basal membrane, and lamina propria. In the transmission and scanning electron microscopy (TEM and SEM) studies, eight new cases of polyps were included. An immunohistochemical study was carried out in the 42 specimens, using antibody antifibronectin, antilaminin, and anticollagen IV.
Results
Genders—43% males and 57% females; age range—between 21 and 40 years (36.85%); and between 41 and 60 years of age (51.31%); smoking and drinking—reported by 39 and 15 patients, respectively; associated symptoms—vocal abuse (61%), gastroesophageal (47%), and nasosinusal symptoms (32%); occupation—teachers (24.0%) and maids (18.0%). Histology—epithelial hyperplasia (31.71%), hyperkeratosis, (14.28%), edema (100%), vessel proliferation (92.86%), and congestion (83.33%). SEM—reduction in mucous lacing and increase in desquamating cells. TEM—hyperplastic epithelium, enlargement of the intercellular junctions, dense subepithelial network of collagen and basal membrane with adhesion loss. Immunohistochemistry—greater immunoexpression of fibronectin, laminin, and collagen IV around the vessels.
Conclusions
In vocal polyps, the morphological analyses show lamina propria with edema, vessel proliferation and inflammation, basement membrane with adhesion loss in some areas and dense network of subepithelial collagen. Immunohistochemistry techniques identify pigmentation of the antibodies anti-fibronectin, anti-laminin, and anti-collagen IV in the endothelium of blood vessels.
∗Department of Otorhinolaryngology, Ophthalmology and Head and Neck Surgery, School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
†Department of Pathology, School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil
Address correspondence and reprint requests to Regina Helena Garcia Martins, Disciplina de Otorrinolaringologia, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço da Faculdade de Medicina de Botucatu, Distrito de Rubião Junior, Botucatu (SP), CEP: 18618-970, Brazil.
This study was financially supported by the State of São Paulo Research Foundation (FAPESP).
ABSTRACT