MORPHOLOGICAL-STUDIES ON THE PATHOGENESIS OF REINKES EDEMA

Light microscopy of vocal cord mucosa in patients with Reinke's edema revealed highly ramified fissured spaces in the subepithelial tissue t hat were generally lined with flat cells. The ultrastructure of the pa rietal cells resembled fibroblasts whose cytoplasmic extensions overla pped in two to three layers in some places. Cell contacts were not obs erved. Neither electron microscopy nor immunohistochemical testing wit h antibody against laminin demonstrated a basal membrane. It was possi ble to distinguish between Light and dark cells in the specimens exami ned. The cytoplasm of the light cells contained intermediate filaments , mitochondria, lysosomes, coated vesicles, caveolae and broad cistern ae of rough endoplasmic reticulum. The dark eels were more numerous an d typically exhibited a well-developed endoplasmic reticulum and free ribosomes:; The parietal cells showed no immunoreaction against human vascular endothelial cells. Immunohistochemical demonstration of mesen chymal 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 c ells with monoclonal antibody against macrophages (KiM6). These findin gs 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 th e hollow spaces of Reinke's edema develop like neobursae from mechanic al strain.