Tumours of the Larynx

1 Development, Anatomy, Spatial Compartments and Regions.- 1.1 Development.- 1.2 Postnatal Changes.- 1.3 Anatomy.- 1.3.1 Laryngeal Framework.- 1.3.2 Ligaments and Membranes.- 1.3.3 Muscles.- 1.3.4 Blood Vessels.- 1.3.5 Lymph Drainage.- 1.4 Regional and Spatial Division.- 1.4.1 Spatial Subdivision.- 1.4.2 Regions and Sites.- 2 Particular Problems of Histological Preparation and Assessment: Advanced Methods.- 2.1 Whole-Organ Serial Sections.- 2.2 Histological Evaluation.- 2.2.1 Plane of Section.- 2.2.2 Grading.- 2.3 Advanced Methods in the Evaluation of Precancerous Lesions and Carcinomas.- 2.3.1 Predominantly Morphological Methods.- 2.3.1.1 Exfoliative and Aspiration Cytology.- 2.3.1.2 Quantification of Histopathology.- 2.3.1.3 Histochemistry.- 2.3.1.4 Immunohistochemistry.- 2.3.1.5 In Situ Hybridization.- 2.3.1.6 Electron Microscopy.- 2.3.2 Additional, more Functional Methods.- 2.3.2.1 Cellular Proliferation Studies.- 2.3.2.2 DNA Histograms, Cytophotometry.- 2.3.2.3 Changes in Immune Status.- 2.3.2.4 Analysis of Cell Products in Circulating Blood.- 2.3.2.5 Examination of Living Tissue.- 2.3.2.6 Experimental Models.- 2.3.3 Conclusion.- 2.4 Advanced Methods in the Determination of Tumour Types.- 3 Benign Neoplasms.- 3.1 Definition, Classification, Frequency, General Therapeutic Aspects.- 3.2 Epithelial Tumours.- 3.2.1 Papilloma and Papillomatosis.- 3.2.1.1 Juvenile-Onset Papilloma.- 3.2.1.2 Adult-Onset Papilloma.- 3.2.2 Oxyphilic Adenoma (Oncocytoma).- 3.2.3 Other Adenomas.- 3.3 Tumours of Soft Tissue.- 3.3.1 Mesenchymal Tumours.- 3.3.1.1 Fibroma, Histiocytoma, Myxoma and Mesenchymoma.- 3.3.1.2 Lipoma.- 3.3.1.3 Angioma.- 3.3.1.4 Leiomyoma.- 3.3.1.5 Rhabdomyoma.- 3.3.2 Tumours of the Peripheral Nervous System.- 3.3.2.1 Neurilemmoma (Schwannoma, Neurinoma).- 3.3.2.2 Neurofibroma.- 3.3.2.3 Paraganglioma, Chemodectoma.- 3.3.2.4 Granular Cell Tumour.- 3.3.2.5 Ganglioneuroma.- 3.4 Tumours of Cartilaginous and Osseous Tissue.- 3.4.1 Chondroma.- 3.4.2 Osteoma.- 3.4.3 Giant Cell Tumour.- 3.5 Tumours of the Lymphatic and Haematopoietic System.- 3.5.1 Plasmocytoma.- 3.6 Miscellaneous Tumours, Malformations.- 4 General Conditions and Risk Factors of Carcinogenesis, Precancerous Lesions.- 4.1 Incidence, Age, Sex Distribution and Risk Factors.- 4.1.1 Incidence.- 4.1.2 Age, Sex Distribution and Hormonal Factors.- 4.1.3 Endogenous Factors.- 4.1.4 Exogenous Risk Factors: Tobacco and Alcohol.- 4.1.5 Inhaled Noxious Agents.- 4.1.6 Differences in Geographical Distribution-Occupational Risks.- 4.2 Papilloma/Papillomatosis and Viral Infection in Laryngeal Carcinogenesis.- 4.3 Chronic Laryngitis.- 4.4 Epidermoid Metaplasia.- 4.5 Multitopic (Multicentric) Tumour Growth: Field Cancerization.- 4.6 Precancerous Lesions.- 4.6.1 Macroscopic Clinical Aspects: Leukoplakia, Erythroplakia.- 4.6.2 Histological Assessment and Classification of Dysplasia.- 4.6.2.1 Criteria of Epithelial Hyperplasia and Epithelial Dysplasia.- 4.6.2.2 Grades of Dysplasia.- 4.7 Carcinoma in Situ, Microinvasive Carcinoma.- 4.8 Evaluation of Histological Finding.- 4.9 Therapy of Dysplasia and Carcinoma In Situ of the Larynx.- 5 Squamous Cell Carcinomas.- 5.1 Origin and Spread of Carcinomas.- 5.1.1 Supraglottic Carcinomas.- 5.1.2 Glottic-Supraglottic Boundary.- 5.1.3 Glottic and Subglottic Carcinomas.- 5.1.4 "External Laryngeal Carcinomas" (Hypopharnyx, Lower Oropharynx).- 5.2 Metastasis.- 5.2.1 Lymphatic Metastasis of Internal and External Laryngeal Carcinomas.- 5.2.2 Distant Metastasis.- 5.3 TNM Classification of Laryngeal, Hypopharyngeal and Caudal Oropharyngeal Carcinoma.- 5.3.1 Pretherapeutic TNM Classification.- 5.3.1.1 Larynx.- 5.3.1.2 Hypopharynx.- 5.3.1.3 Oropharynx.- 5.3.1.4 Regional Lymph Nodes.- 5.3.1.5 Distant Metastases.- 5.3.2 pTNM Classification.- 5.4 Histology of Squanomous Cell Carcinoma.- 5.4.1 Degree of Differentiation.- 5.4.2 Tumour-Host Relationship.- 6 Management of Laryngeal Cancer and Histopathological Inferences.- 6.1 Diagnosis and Prevention.- 6.1.1 Diagnostic Procedures, Computerized Tomography.- 6.1.2 Prevention.- 6.2 Surgery.- 6.2.1 Conservative Surgery of Glottic Cancer.- 6.2.1.1 Outline of Techniques.- 6.2.1.2 Results of Differential Surgical Procedures.- 6.2.1.3 Comment and Conclusion.- 6.2.2 Conservative Surgery of Supraglottic Cancer.- 6.2.2.1 Techniques.- 6.2.2.2 Surgical Procedures and Results.- 6.2.3 Radical Surgery of Laryngeal and Laryngopharyngeal Cancer.- 6.2.4 Management of Regional Metastasis.- 6.3 Radiation Therapy.- 6.3.1 The Biology of Irradiated Tumours.- 6.3.2 Histological Changes in Irradiated Carcinomas.- 6.3.3 Preoperative Irradiation.- 6.3.3.1 Histological Changes in Preoperatively Irradiated Carcinomas: The Periphery-Basis Gradient.- 6.3.3.2 Regions of Diminished Radiation Effect.- 6.3.3.3 Effect of Irradiation on Lymph Node Metastasis.- 6.3.4 Late Results After Preoperative Irradiation of Squamous Cell Carcinomas of the Larynx.- 6.3.4.1 Local Recurrences.- 6.3.4.2 Regional Recurrences.- 6.3.4.3 Late Distant Metastasis.- 6.3.4.4 Survival Rates.- 6.4 Changes Following Treatment with Cytostatic Agents.- 7 Unusual Malignant Tumours.- 7.1 Special Forms of Squamous Cell Carcinoma.- 7.1.1 Special Forms of Squamous Cell Carcinoma.- 7.1.1.1 Verrucous Carcinoma.- 7.1.1.2 Spindle Cell Carcinoma and Carcinosarcoma.- 7.1.1.3 Transitional Cell Carcinoma.- 7.1.1.4 Lymphoepithelial Carcinoma.- 7.1.2 Carcinomas of the Adnexa of the Laryngeal Mucosa.- 7.1.2.1 Adenocarcinoma.- 7.1.2.2 Adenoid Cystic Carcinoma.- 7.1.2.3 Mucoepidermoid Carcinoma.- 7.1.3 Other Forms of Carcinoma.- 7.1.4 Metastatic Cancer.- 7.2 Nonepithelial Malignant Tumours.- 7.2.1 Malignant Mesenchymal Tumours (Sarcomas).- 7.2.1.1 Fibrosarcoma and Malignant Fibrous Histiocytoma.- 7.2.1.2 Chondrosarcoma.- 7.2.1.3 Rhabdomyosarcoma.- 7.2.1.4 Leiomyosarcoma.- 7.2.1.5 Angiosarcoma.- 7.2.1.6 Malignant Lymphoma.- 7.2.1.7 Other Malignant Mesenchymal Neoplasms.- 7.2.2 Malignant Neuroectodermal Tumours.- 7.2.2.1 Malignant Melanoma.- 7.2.2.2 Chemodectoma (Paraganglioma).- 7.3 Radiogenic Tumours.- 8 Pseudotumours of the Larynx.- 8.1 Inflammatory Pseudotumours.- 8.1.1 Vocal Cord Polyps.- 8.1.2 Vocal Cord Nodules.- 8.1.3 Intubation Granulomas.- 8.1.4 Contact Hyperplasia.- 8.1.5 Infectious Laryngeal Tumours.- 8.1.6 Sarcoidosis.- 8.1.7 Other Granulomas and Granulomatoses.- 8.1.8 Histologically Pseudomalignant Lesions.- 8.2 Laryngeal Cysts and Laryngoceles.- 8.2.1 Laryngeal Cysts.- 8.2.2 Laryngoceles.- 8.3 Metabolically Induced Pseudotumours.- 8.3.1 Amyloid Tumours.- 8.3.2 Gout Tophi.- 8.3.3 Other Metabolically Induced Pseudotumours.- 8.4 Endolaryngeal Thyroid Tissue.- References.