PMC6815980_01
The appearance of lesion the first time the patient visited the hospital; warts located at the right ventricular band, inside of the arytenoid cartilage, and on the laryngeal side of the epiglottis.
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The patient then went to a local hospital and a direct laryngoscope examination was performed, which showed that inside of the arytenoid cartilage, on the laryngeal side of the epiglottis, and at the right ventricular band were located multiple masses of warty lesions with a cauliflower-like appearance (Figure 1).
Initial biopsy during the first visit (a) Vacuolar degeneration in epithelium cells (magnification x200). (b) Mild atypical hyperplasia in epithelium (magnification x400). (c) Ki-67 antibody labelling index was 10% (magnification x100). (d) Human papillomavirus (HPV) was detected in the patient's laryngeal tissue sample (red arrow) (magnification x200).
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Histopathological examination was performed, and the pathology report showed papillomatous hyperplasia of the mucous epithelium, hypergranulosis, mild atypical hyperplasia (Figure 2(b)), and vacuolar degeneration in epithelium cells were observed (Figure 2(a)). Further immunohistochemical staining showed the Ki-67 antibody labelling index was 10% (Figure 2(c)), and human papillomavirus (HPV) was detected and was HPV-16-positive (Figure 2(d)).
The appearance of recurrent lesion when the patient visited our hospital; the lesion was located at the laryngeal side of the epiglottis and inside of the arytenoid cartilage.
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Repeat laryngoscopy showed the neoplasm resurfaced and the lesion located at the laryngeal side of the epiglottis and inside of the arytenoid cartilage (Figure 3).
Biopsy of the patient when the patient visited our hospital. (a) Magnification x200 showing the similar appearance like the fist time. (b) Magnification x40 showing Ki-67 is 10% positive in the sample. (c) Magnification x200 showing HPV-16 was found in the lesion (red arrow).
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The pathological changes showed papillomatous hyperplasia of the mucous epithelium and vacuolar degeneration in epithelium cells as noted the first time (Figure 4(a)). The histopathological change showed the characteristics of HPV infection, the immunohistochemical findings showed the lesion with a low proliferation index (Ki-67 10% positive) (Figure 4(b)), and HPV-16 was found in the lesion (Figure 4(c)).
Six months after therapy. No recurrence was found in the epiglottis and around the glottis.
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There was no recurrence found under laryngoscopy after six months of the surgery (Figure 5), and recurrence was not found during telephone follow-up 15 months after CO2 laser therapy and PDT treatment.