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Mild squamous dysplasia causing laryngeal leukoplakia

last modified on: Mon, 03/18/2024 - 09:47

return to: Laryngeal leukoplakia white plaques on vocal cords or Overview of squamous dysplasia

see also: Moderate squamous dysplasia causing laryngeal leukoplakia 

Note: last updated before 2017

Mild squamous dysplasia shows the lowest degree of cytoarchitectural abnormality. Generally the disordered architecture, i.e., basal layer expansion, loss of polarity, mitoses, etc., is limited to the lower third of the mucosa and the cytological abnormalities are considered minimal to mild. A very important caveat in grading this low degree of dysplasia is to exclude the presence of an inflammatory infiltrate within the mucosa from which the cytologic atypia may be derived. Overall, these types of lesions carry a significantly lower risk of progression to malignancy as compared to higher grades of dysplasia.

Mild squamous dysplasia

Mild dysplasia shows disordered architecture and nuclear hyperchromatism and pleomorphism that is limited to the basal third. Overlying hyperkeratosis with a granular cell layer is noted.

In this biopsy there is architectural disorder, nuclear hyperchromatism and pleomorphism, and increased mitoses (black arrows) that are above the basal zone.

Mild dysplasia in this biopsy is confirmed by the nuclear hyperchromatism and pleomorphism in the basal third, as well as architectural disorder that is characterized by hypercellular (black, solid oval) and hypocellular zones (black, dotted oval).

Mild dysplasia showing pleomorphic and hyperchromatic cells coming off of a disordered basal layer. Orthokeratin and a prominent granular cell layer is present.

References

Zidar N, Gale N. Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Hypopharynx, Larynx, Trachea and Parapharyngeal Space. Head Neck Pathol. 2022 Mar;16(1):31-39. doi: 10.1007/s12105-021-01405-6. Epub 2022 Mar 21. PMID: 35312977; PMCID: PMC9018940.

Hrelec C. Management of Laryngeal Dysplasia and Early Invasive Cancer. Curr Treat Options Oncol. 2021 Aug 23;22(10):90. doi: 10.1007/s11864-021-00881-w. PMID: 34424405.