Examination of micro-superficial lesions of up to 5 mm in size in the pharyngolaryngeal region

J Laryngol Otol. 2023 Jul;137(7):749-756. doi: 10.1017/S0022215122001761. Epub 2022 Aug 2.

Abstract

Objective: For low-grade intraepithelial neoplasia cases, pharyngolaryngeal lesions equal to or less than 5 mm in size do not generally progress to invasive carcinoma. However, micro-superficial lesions equal to or less than 5 mm that showed rapid growth have been recently encountered. This study aimed to identify the characteristics of preferential progression of lesions equal to or less than 5 mm in size.

Method: Gross findings, endoscopic findings and pathological results of 55 lesions measuring equal to or less than 5 mm in diameter were retrospectively reviewed to identify factors that distinguish squamous cell carcinoma or high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia or non-atypia lesions.

Results: The overall sensitivity, specificity, accuracy, and positive and negative predictive value of background colouration and intrapapillary capillary loop pattern in differentiation of squamous cell carcinoma or high-grade intraepithelial neoplasia from low-grade intraepithelial neoplasia or non-atypia lesions were all 100 per cent.

Conclusion: Diagnosis based on background colouration and the intrapapillary capillary loop pattern on narrow-band imaging facilitates the pathological examination of lesions measuring equal to or less than 5 mm.

Keywords: Early Detection Of Cancer; Head And Neck Neoplasms; Narrow Band Imaging; Pharyngeal Neoplasms.

MeSH terms

  • Carcinoma in Situ* / diagnostic imaging
  • Carcinoma in Situ* / pathology
  • Carcinoma, Squamous Cell* / diagnosis
  • Carcinoma, Squamous Cell* / pathology
  • Humans
  • Narrow Band Imaging / methods
  • Predictive Value of Tests
  • Retrospective Studies