Abstract
Light microscopy of vocal cord mucosa in patients with Reinke's edema revealed highly ramified fissured spaces in the subepithelial tissue that were generally lined with flat cells. The ultrastructure of the parietal cells resembled fibroblasts whose cytoplasmic extensions overlapped in two to three layers in some places. Cell contacts were not observed. Neither electron microscopy nor immunohistochemical testing with antibody against laminin demonstrated a basal membrane. It was possible to distinguish between light and dark cells in the specimens examined. The cytoplasm of the light cells contained intermediate filaments, mitochondria, lysosomes, coated vesicles, caveolae and broad cisternae of rough endoplasmic reticulum. The dark cells were more numerous and typically exhibited a well-developed endoplasmic reticulum and free ribosomes. The parietal cells showed no immunoreaction against human vascular endothelial cells. Immunohistochemical demonstration of mesenchymal intermediate filaments using antibody against vimentin yielded a positive reaction for some of the cells in the walls of the crevices and subepithelial tissue. It was also possible to demonstrate a few cells with monoclonal antibody against macrophages (KiM6). These findings contradict the concept of lymphatic distension in cases of Reinke's edema. Since the parietal cells seen resembled synoviocytes in their structure and immunohistochemical reactions, findings indicate that the hollow spaces of Reinke's edema develop like neobursae from mechanical strain.
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References
Fuchs B (1989) Zur Pathogenese und Klinik des Reinke-Ödems. HNO 37:490–495
Ghadially FN (1983) Fine structure of synovial joints. Butterworths, London
Graabaek PM (1985) Fine structure of the lysosomes in the two types of synoviocytes of normal rat synovial membrane. Cell Tissue Res 239:293–298
Hajek M (1925) Beiträge zur Anatomie der Stimmlippe. HNO13:161–172
Hünermann T (1958) Das Reinkesche Stimmlippenödem und Genese. Laryngol Rhinol Otol 37:182–185
ambic V, Gale N, Radsel Z (1989) Die anatomischen Merkmale des Reinke-Raumes und die Atio-Pathogenese des Reinke-Ödems. Laryngol Rhinol Otol 68:318–386
Linck G, Porte A (1978) B-cells of the synovial membrane. I. A comparative ultrastructural study in some mammals. Cell Tissue Res 187:251–261
Nehrlich AG, Schleicher E (1991) Identification of lymph and blood capillaries by immunohistochemical staining for various basement membrane components. Histochemistry 96:449–453
Parwaresch R, Radzun HJ, Kreipe H, Hausmann ML, Barth J (1986) Monocyte/macrophage reactive monoclonal antibody Ki-M6 recognizes an intracytoplasmic antigen. Am J Pathol 125:141–151
Reinke F (1895) Untersuchungen über das menschliche Stimmband. Fortschr Med 13:469–478
Reinke F (1897) Funktionelle Struktur der menschlichen Stimmlippe mit besonderer Berücksichtigung des elastischen Gewebes. Anat Hefte 9:104–115
Remendr E, Elö J, Frint T (1984) The morphological basis for development of Reinke's oedema. Acta Otolaryngol (Stockh) 97:169–176
Tillmann B, Rudert H (1982) Licht- und elektronenmikroskopische Untersuchungen zum Reinkebdem. HNO 30:280–284
Tillmann B, Rudert H, Lange G (1993) Morphologische Untersuchungen: Pathogenese des Reinke-Ödems. Eur Arch Otorhinolaryngol (Verhandlungsbericht 1993) Suppl II: 280
Timpl R, Rohde H, Robey PG, Rennard SI, Foidart JM, Martin GR (1979) Laminin: a glycoprotein from basement membranes. J Biol Chem 254:9933–9937
White A, Sim DW, Maran GD (1991) Reinke's oedema and thyroid function. J Laryngol Otol 105:291–292
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Tillmann, B., Rudert, H., Schünke, M. et al. Morphological studies on the pathogenesis of Reinke's edema. Eur Arch Otorhinolaryngol 252, 469–474 (1995). https://doi.org/10.1007/BF02114753
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DOI: https://doi.org/10.1007/BF02114753