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Benign Pathologic Responses of the Larynx

Benign laryngeal lesions were examined for patterns of injury indicated by deposition of fibronectin and collagen type iv. An immunoperoxidase technique was used to compare 33 fresh or paraffin-embedded tissues with regard to their staining of monoclonal antibodies directed against fibronectin and collagen type iv. Two types of patterns were recognized. One pattern showed intense fibronectin deposition in the superficial layer of the lamina propria, often coupled with basement membrane zone injury, indicated by thick collagen type IV bands. The other pattern showed rare basement membrane zone injury and very little fibronectin deposition. The first pattern correlated more with nodules, the second pattern more with Reinke's edema and some polyps. A better understanding of the effects of excessive deposition of structural glycoproteins such as fibronectin and of abnormal proteoglycan deposition may lead to a better characterization of vocal fold disease and its causation and, ultimately, better treatment.