Laryngeal carcinoma: high-resolution computed tomography and thick anatomic sections

High-resolution 2-mm thick sequential CT scans of 23 patients with primary laryngeal carcinoma were reviewed to judge the value of CT in early tumor detection and the ability of CT to establish tumor extent reliably, particularly early cartilage invasion. False-negative results were likely when superficial lesions were confined to the true vocal cord mucosa. False-positive examinations occurred with vocal cord polyps and with acute and chronic granulomatous reaction of the vocal cords. In tumors large enough to be imaged, there were no false negatives. False-positive results for clearly identified tumors were related to the interpretation of tumor on CT where only edema was present at surgery. Both early and gross cartilage invasion were well correlated with surgically resected specimen sections. Early cartilage involvement by tumor can be detected by the development of a fenestrated chondral margin. Other benign expansive cartilage processes, such as occur with chondromas, have calcified cartilage fragment distributions that are out of proportion to any soft-tissue mass present.