Vocal polyps: clinical, morphological, and immunohistochemical aspects.
OBJECTIVE
To study the clinical, morphological, and immunohistochemical characteristics of vocal polyps.


METHODS
Prospective and retrospective.


METHODS
Clinical study: 76 medical charts from patients with polyps were reviewed. Histology study: in 42 slides from surgical specimens, the following were analyzed: epithelium, basal membrane, and lamina propria. In the transmission and scanning electron microscopy (TEM and SEM) studies, eight new cases of polyps were included. An immunohistochemical study was carried out in the 42 specimens, using antibody antifibronectin, antilaminin, and anticollagen IV.


RESULTS
Genders--43% males and 57% females; age range--between 21 and 40 years (36.85%); and between 41 and 60 years of age (51.31%); smoking and drinking-reported by 39 and 15 patients, respectively; associated symptoms-vocal abuse (61%), gastroesophageal (47%), and nasosinusal symptoms (32%); occupation--teachers (24.0%) and maids (18.0%). Histology--epithelial hyperplasia (31.71%), hyperkeratosis, (14.28%), edema (100%), vessel proliferation (92.86%), and congestion (83.33%). SEM--reduction in mucous lacing and increase in desquamating cells. TEM--hyperplastic epithelium, enlargement of the intercellular junctions, dense subepithelial network of collagen and basal membrane with adhesion loss. Immunohistochemistry--greater immunoexpression of fibronectin, laminin, and collagen IV around the vessels.


CONCLUSIONS
In vocal polyps, the morphological analyses show lamina propria with edema, vessel proliferation and inflammation, basement membrane with adhesion loss in some areas and dense network of subepithelial collagen. Immunohistochemistry techniques identify pigmentation of the antibodies anti-fibronectin, anti-laminin, and anti-collagen IV in the endothelium of blood vessels.
Martins
Regina Helena Garcia
RH
Department of Otorhinolaryngology, Ophthalmology and Head and Neck Surgery, School of Medicine, São Paulo State University, Botucatu, São Paulo, Brazil. rmartins@fmb.unesp.br
Defaveri
Julio
J
Domingues
Maria Aparecida Custódio
MA
de Albuquerque e Silva
Rafael
R
D000328:Adult; D001485:Basement Membrane / Q000737:chemistry / Q000473:pathology; D015415:Biomarkers / Q000032:analysis; D024141:Collagen Type IV / Q000032:analysis; D004847:Epithelial Cells / Q000737:chemistry / Q000473:pathology; D005260:Female; D005353:Fibronectins / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D007797:Laminin / Q000032:analysis; D007818:Laryngeal Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D007828:Laryngoscopy; D008297:Male; D008855:Microscopy, Electron, Scanning; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D011127:Polyps / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D011446:Prospective Studies; D012189:Retrospective Studies; D014827:Vocal Cords / Q000737:chemistry / Q000473:pathology*; D055815:Young Adult
D015415:Biomarkers; D024141:Collagen Type IV; D005353:Fibronectins; D007797:Laminin