Kenji Koshii

LARYNGEAL EPITHELIAL CHANGES ON EFFECTS OF SMOKING AND DRINKING

The human larynx is essential not only for speech, but also for swallowing and respiration. Its tissues are affected by the presence of alcohol and cigarette smoke. In this report we present our findings on the effects of smoking and drinking on histological changes in laryngeal tissue. The larynges studied were those of autopsy patients: cases with damaged tissue were excluded. We studied the larynges of 84 men (non-smoker and non-drinker, 22 cases; smoker and drinker, 62 cases) and 48 women (non-smoker and non-drinker, 40 cases; smoker and drinker, 8 cases) between the ages of 12 and 88. The squamous metaplasia of laryngeal epithelium was examined using the gross staining method (Pyronin Y) of STELL et al. (J. Laryngeal. Otol. 86: 589-594, 1972). The squamous epithelium is unstained, whereas the respiratory epithelium is a brilliant red. The area of metaplasia in the supraglottic region increased with aging, tobacco and alcohol consumption. Microscopic changes of the laryngeal epithelium were investigated using the hematoxylin-eosin staining method. The thickness of epithelium of the supraglottic region and vocal cord increased with age. There is a significant difference in the thickness of the epithelium of the supraglottic region and vocal cords of smoking and drinking patients, when compared with the same tissues of non-smokers and non-drinkers. Furthermore, there is a significant difference in those tissues of the supraglottic region of heavy smokers, when compared with light smokers, but no significant difference when compared with drinkers. However, there is no significant difference in the thickness of vocal cord tissues when comparing light smokers and drinkers on the one hand, and heavy smokers and drinkers on the other.

Fibrosarcoma of the Neck in an Adult Female

This paper is a case report of a 53-year-old housewife with fibrosarcoma of the neck. On 27 August 1986, she was admitted to our hospital with discomfort on the right side of her throat and difficulty in swallowing. She had no history of radiation therapy to the neck. The tumor was below the right submandibular gland and was movable. No enlarged lymph nodes were palpated in the neck. The mean CT number of the tumor was 59.5 H.U. The tumor was almost circular and its surface was smooth. Upon operating, the tumor was observed to be connected to the greater cornu of the hyoid bone and the superior cornu of the thyroid cartilage. The tumor measured 50 x 42 x 35 mm and was well circumscribed but not encapsulated. The cut surfaces were generally fleshy, glistening and grayish-white. The tumor was composed of small amounts of collagen and reticulin, producing fairly uniform spindle cells arranged in interlacing bundles, forming a herring bone pattern. The tumor cell showed rather little atypism, but did show obvious mitotic activity. Thus, the tumor was diagnosed as well-differentiated fibrosarcoma. When the patient was last seen, in April 1989, there was no evidence of recurrence.