背景:最初在唾液腺多形性腺瘤中描述了富含酪氨酸或酪氨酸样晶体(TC)。TC在非肿瘤组织中的存在是罕见的,据报道,它只存在于喉部。这项研究旨在表征全喉切除术标本中TC的频率和解剖定位。
方法:回顾连续的喉切除术标本,其中盒式总结记录了左右声带和前连合的矢状面旁切片采样。收集的数据包括患者人口统计学,潜在的诊断,放射治疗史,存在,和TC的位置。
结果:在86个喉切除标本中,16(19%)含有两性至嗜酸性的TC。该研究队列包括11名男性和5名女性,年龄37至85岁(平均62岁,中位数63岁)。晚期未经治疗的鳞状细胞癌(SCCa)进行喉切除术(7/16,43.75%),治疗后复发SCCa(7/16,43.75%),以前未经治疗的喉大细胞神经内分泌癌(1/16,6.25%),放化疗后喉无功能(1/16,6.25%)。根据宏观卡带总结,主要在前连合部分发现TC。(13/16,81.25%),在包含左侧(2/16,12.5%)或右侧(1/16,6.25%)声带的切片中,病例较少。微观上,TC位于黄斑前黄和/或邻近的声带韧带(12/16,75%)和前连合肌腱(4/16,25%)。
结论:据报道,TC主要与肿瘤混合,然而,这项研究证实,TC也可以发生在喉部的非肿瘤组织中。TC的存在与先前的放射治疗之间没有明确的关系。黄斑黄花的特殊结缔组织中的TC和与肿瘤不同的真索肌腱插入可能响应于机械应力的改变而形成,尽管正常喉部显微解剖结构范围内的年龄相关变化仍有可能。
BACKGROUND: Tyrosine-rich or tyrosine-like crystalloids (TC) were initially described in salivary gland pleomorphic adenoma. The presence of TC in non-neoplastic tissues is rare, and it has been reported exclusively in the larynx. This study aims to characterize the frequency and anatomical localization of TC in total laryngectomy specimens.
METHODS: Review of consecutive laryngectomy specimens in which the cassette summary documented parasagittal section sampling of the right and left vocal folds and the anterior commissure. Data collected included patient demographics, underlying diagnoses, history of radiation therapy, presence, and location of TC.
RESULTS: Of 86 laryngectomy specimens, 16 (19%) contained amphophilic to eosinophilic TC. The study cohort included 11 males and 5 females, aged 37 to 85 years (mean 62, median 63). Laryngectomy surgery was performed for advanced untreated squamous cell carcinoma (SCCa) (7/16, 43.75%), recurrent post-treatment SCCa (7/16, 43.75%), previously untreated laryngeal large cell neuroendocrine carcinoma (1/16, 6.25%), and non-functional larynx post-chemoradiation (1/16, 6.25%). According to the macroscopic cassette summary, TC were predominantly found in the anterior commissure Sect. (13/16, 81.25%), with fewer cases in sections containing the left (2/16, 12.5%) or the right (1/16, 6.25%) vocal folds. Microscopically, TC localized to the anterior macula flava and/or adjacent vocal ligament (12/16, 75%) and the anterior commissure tendon (4/16, 25%).
CONCLUSIONS: TCs are predominantly reported as admixed with a neoplasm, however this study confirms that TC can also occur in non-neoplastic tissues of the larynx. There was no clear relationship between the presence of TC and prior radiation therapy. TC in the specialized connective tissues of the macula flava and true cord tendinous insertions distinct from tumor may form in response to alterations in mechanical stress, though an age-related change within the spectrum of normal laryngeal microanatomy also remains a possibility.