No abstract

Review of the literature reveals 76 cases of fibrous histiocytoma of the deep structures of the head and neck. To this we have added 11 of our own cases, and analyzed the total group to determine clinical and histological features of a high risk population. Age, sex, presence of pain, location of tumor, size of tumor, and local invasion appear to be important clinical criteria. Bizarre giant cells, numerous and atypical mitoses, necrosis, and inflammation appear to be important histologic features. The treatment of choice is wide local excision. Chemotherapy appears to produce tumor regression.

Dendritic cells containing melanin pigment have been demonstrated with silver impregnation and bleaching techniques in the nasal cavities of both Caucasians and Negroes. They were found in the respiratory epithelium, nasal glands and commonly in the superficial and deep stroma of the septum and middle and inferior turbinates, particularly in adult Negroes. The presence of melanocytes explains the histogenesis of melanomas of the nasal cavity as primary neoplasms at this site.

Two pairs of glomic bodies (“paraganglia”) occur in the larynx as originally described by German authors. They were independently found in 18 of 25 serially sectioned adult larynges. The superior laryngeal glomus is situated in the supraglottic larynx in the adult and neonate. The inferior laryngeal glomus is positionally more variable, usually occurring between the cricoid cartilage and the first tracheal ring in the adult and may extend to the thyroid gland. Three neonatal larynges were also examined for comparison. The glomera show no developmental enlargement and appear histologically identical. No glomic tissue was found in neonatal tracheas. Reports of laryngeal paraganglionic tumors or chemodectomas are reviewed and show anatomic correlation with the naturally occurring bodies.

During the study of serially sectioned cancerous and irradiated larynges, a unique case of extensive melanosis of the laryngeal mucosa was encountered. While pigmented neoplasms in the larynx had been reported repeatedly, to our knowledge the presence of melanocytes had not been demonstrated at that site; consequently, we initiated a study to ascertain whether melanocytes were present in the human larynx as an explanation for the histogenesis of these neoplasms. We adopted the technique of Epstein for stripping the laryngeal mucosa, and of Nigogosyan and coworkers for embedding and sectioning the ribbons of tissue. In an ongoing study, using non‐selected adult larynges removed at autopsy, scattered foci of melanocytes were found in an appreciable number of Caucasian and Negro specimens. With the Masson‐Fontana silver procedure for melanin, they appear as dendritic cells containing black granular pigment, situated in the basal layer of the squamous epithelium and subjacent connective tissue. While the origin of melanomas from pigment containing cells in the skin, eye and leptomeninges is well established, the histogenesis of those tumors arising in non‐integumentary and extra‐ocular sites remains obscure, because with few exceptions melanocytes have not been demonstrated in these organs. Melanocytes have been observed in the esophagus, oral cavity, vagina, and now larynx. Theories attempting to explain their presence at nonectodermal sites include the migration of melanoblasts with mesoderm to visceral sites, the transformation of neural crest elements into melanocytes and nevus cells, as well as the metaplasia of both squamous and glandular epithelium into pigment producing cells.