HISTOPATHOLOGICAL REMODELLING IN BENIGN VOCAL FOLD LESIONS: MORPHOLOGICAL PATTERNS AND IL-6/MMP-9 IMMUNOREACTIVITY

Background: Benign vocal fold lesions are important causes of dysphonia, but nodules, polyps and cysts differ in tissue architecture and remodelling. Histopathology describes these differences, while immunohistochemistry for interleukin-6 (IL-6) and matrix metalloproteinase-9 (MMP-9) may provide additional information about inflammation and extracellular-matrix turnover. This study characterises the reported tissue patterns and compares available IL-6/MMP-9 immunoreactivity data for nodules and polyps. Methods: The manuscript synthesises histological descriptions and photomicrographs in the supplied clinical manuscript with the available morphometric and immunohistochemical summary tables. The clinical series included 102 patients: 34 with nodules, 40 with polyps and 28 with cysts. The separate IHC tables reported 22 nodule specimens, 20 polyp specimens and 40 controls. Features included epithelial hyperplasia, basement-membrane changes, fibrosis, hyalinosis, stromal oedema, vascular changes and inflammatory infiltration. IL-6 and MMP-9 were reported as H-scores. Results: Nodules showed epithelial hyperplasia, focal parakeratosis, basement-membrane thickening, lamina-propria fibrosis and chronic lymphoplasmacytic infiltration. Polyps showed stromal oedema, myxoid change, dilated thin-walled vessels and perivascular inflammation. Cysts showed a circumscribed subepithelial cavity with epithelial lining and a fibrous wall. In the IHC summaries, nodules had IL-6 and MMP-9 H-scores of 72.4±15.6 and 58.7±14.2, respectively, compared with 18.5±7.2 and 15.1±6.4 in controls. Polyps had scores of 86.1±18.4 and 76.5±17.8. Source tables mark lesion-versus-control differences as p<0.05, but exact p-values and tests were not supplied. Conclusions: The source material supports distinct morphological patterns across nodules, polyps and cysts. Available IHC summaries indicate higher IL-6 and MMP-9 immunoreactivity in nodules and polyps than in controls. These observations are hypothesis-generating; the discrepancy between clinical and IHC sample sizes, missing assay details and incomplete cyst IHC data must be resolved before submission.