Does immunohistochemistry play a role in the assessment of leukoplakic vocal fold lesions?

Introduction Vocal Fold Leukoplakia may show histological variability in their dignity. Dysplasias and carcinomas are treated differently compared to non-dysplastic lesions. Laryngeal dysplasias can be classified as low- and high-grade dysplasias according to WHO classification 2017. Sometimes there are deviation between the clinical endoscopic assessment and the result in histopathology. Immunohistochemistry can be a supportive procedure in confirmatory diagnosis.

Subject and Methods Surgery reports were compared with histological results of patients who presented between 2014-2018 with a vocal fold leukoplakia in our clinic. The cases were examined with regard to their deviation between the intraoperative assessment of the surgeon and the result of the histopathological examination. The result was a deviation score ranging between 0-3. Only cases with a medium and high deviation score were considered (score 2&3). The endoscopic procedures available to the surgeon were white light endoscopy and narrow band imaging.

Results A total of 549 procedures were examined. Of these, 35 resulted in a medium or high deviation score (6.38 % of procedures). The pathologist used the immunohistochemical markers CD31, CD 34, VEGF, p16, p53 and MiB1 in addition to the classical H&E staining. Different staining patterns resulted. Thus the diagnosis could be confirmed or completed.

Conclusion Immunohistochemistry can be used as a supportive procedure. It may be of particular importance if the clinical findings of endoscopic diagnostics and the histopathological findings of H&E staining differ considerably.

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Publication History

Article published online:
10 June 2020