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Juvenile laryngeal papilloma displaying malignant degeneration--a spectrophotometric investigation
Spontaneous malignant degeneration of juvenile laryngeal papilloma in the absence of radiotherapy is exceedingly rare, and few such cases have been reported. The patient reported here, now a woman of 48, has been suffering from recurrent juvenile laryngeal papilloma since she was 13. During the last six years the papillomas have displayed increasing atypia and have spread to the trachea and the bronchus of the right inferior lobe. Recent specimens from the trachea are strongly suggestive of micro-invasive squamous cell carcinoma. The slides from various periods have been reviewed and submitted to spectrophotometric examination to determine the nuclear DNA content and area. For the purpose of comparison, measurements have also been performed on normal squamous vocal cord epithelium, on two juvenile papillomas without atypia, and on one "adult papilloma" with severe atypia. The nuclear DNA absorbance recorded in the patient in question was initially comparable with those for the typical juvenile papillomas and the normal epithelium. The values for the later specimens with increasing atypia, especially those from trachea and bronchus, resemble more closely those for the "adult papilloma" with severe atypia. The results of the spectrophotometric examination are closely consistent with the histological findings.
Spontaneous malignant degeneration of juvenile laryngeal papilloma in the absence of radiotherapy is exceedingly rare, and few such cases have been reported. The patient reported here, now a woman of 48, has been suffering from recurrent juvenile laryngeal papilloma since she was 13. During the last six years the papillomas have displayed increasing atypia and have spread to the trachea and the bronchus of the right inferior lobe. Recent specimens from the trachea are strongly suggestive of micro-invasive squamous cell carcinoma. The slides from various periods have been reviewed and submitted to spectrophotometric examination to determine the nuclear DNA content and area. For the purpose of comparison, measurements have also been performed on normal squamous vocal cord epithelium, on two juvenile papillomas without atypia, and on one "adult papilloma" with severe atypia. The nuclear DNA absorbance recorded in the patient in question was initially comparable with those for the typical juvenile papillomas and the normal epithelium. The values for the later specimens with increasing atypia, especially those from trachea and bronchus, resemble more closely those for the "adult papilloma" with severe atypia. The results of the spectrophotometric examination are closely consistent with the histological findings.