Larynx, hypopharynx & trachea

Precursor epithelial lesions

Reactive epithelial hyperplasia

Last author update: 1 November 2013
Last staff update: 7 March 2023

Copyright: 2002-2023,, Inc.

PubMed Search: Hyperplasia larynx

Nat Pernick, M.D.
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Cite this page: Pernick N. Reactive epithelial hyperplasia. website. Accessed September 26th, 2023.
Definition / general
  • Also called keratosis
  • Usually involves true vocal cords and interarytenoid area
  • Associated with smokers, singers and others who use voices excessively
Gross description
  • White thickening of involved areas
  • Verrucous keratosis if undulating warty configuration
  • Pachyderma larynges if extensive keratinization
Microscopic (histologic) description
  • When in respiratory (ciliated columnar) epithelium (false cord, ventricle, subglottic region), initially hyperplasia of reserve cells under epithelium, then replacement of epithelium by full thickness reserve cells, then complete squamous metaplasia; may have hyperkeratotic epithelium
  • No nuclear abnormalities are present but underlying submucosal glands persist
  • Pseudoepitheliomatous hyperplasia:
    • Exuberant reactive overgrowth of squamous epithelium without atypia
    • May resemble invasive squamous cell carcinoma
Differential diagnosis
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