Squamous epithelial changes of the larynx: diagnosis and therapy

It can be confusing for clinicians to work their way through the tangle of pathologic terms used in surgical pathology reports to describe squamous abnormalities in laryngeal biopsies. After a brief review of the normal microscopic anatomy of the larynx and time-honored clinical designations for surface-based abnormalities, this report sorts pathologic changes into 2 groups: those changes that do not carry a premalignant potential (including squamous metaplasia, squamous hyperplasia, pseudoepitheliomatous hyperplasia, keratosis, and parakeratosis) and those that do (including dyskeratosis, laryngeal intraepithelial neoplasia [LIN], atypia, dysplasia, and carcinoma in situ). Generally, lesions in the first group do not require additional therapy or close follow-up; lesions in the second group, however, demand either some form of local therapy or close follow-up to monitor for the development of a more aggressive pathology.