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Pseudosarcoma of the larynx: the value of ploidy analysis

Published online by Cambridge University Press:  29 June 2007

Michael Cassidy ,
Michael Maher ,
Peader Keogh  and
Mary Leader
Michael Cassidy*
Affiliation:
Department of Pathology, St Luke's and St Anne's Hospital, Dublin. Department of Pathology, Royal College of Surgeons in Ireland and Beamont Hospital, Dublin
Michael Maher
Affiliation:
Department of Oncology, St Luke's and St Anne's Hospital, Dublin
Peader Keogh
Affiliation:
Department of Surgery, Regional Hospital, Limerick, Ireland.
Mary Leader
Affiliation:
Department of Pathology, Royal College of Surgeons in Ireland and Beamont Hospital, Dublin
*
Dr Michael Cassidy, Department of Pathology, Royal College of Surgeons in Ireland, Dublin 2, Ireland. Fax: 01-478 0200.
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Abstract

An 82-year-old male presented with a two-month history of hoarseness. A 2 cm pedunculated lesion was removed from the base of his epiglottis. Microscopy showed a polypoid atypical spindle cell lesion. Multiple levels failed to reveal an invasive squamous cell carcinoma. On the basis of haematozylin and eosin stained sections the main differential diagnosis was a pseudosarcoma with an overlying dysplastic squamous mucosa or infiltrating spindle cell carcinoma. Immunohistochemistry showed positive staining for vimentin but no convincing staining with antibodies to cytokeratin and EMA. Ultrastructural analysis also failed to reveal epithelial characteristics. Ploidy analysis by static cytophotometry of the spindle cell proliferation revealed an aneuploid stem line with a DNA index of 1.67. On the basis of this the process was felt unlikely to be reactive and a diagnosis of a spindle cell squamous carcinoma was made. This diagnosis was subsequently supported by a clinical recurrence of the nodule at a six-month follow-up.

Keywords

LarynxPseudosarcomaCarcinoma, squamousPloidies
Type
Pathology in Focus
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 6 , June 1994 , pp. 525 - 528
Copyright
Copyright © JLO (1984) Limited 1994

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