Relationship Between Vascularization Patterns and
Histopathology
Histopathology revealed benign lesions in 27.5%, malignant lesions in
40%, and dysplastic changes in 32.5% of the cases. The patients
lacking detectable vasculatures (%7.5) included one who presented with
a mass of granulation tissue covered with exudative material, while the
other two presented with leukoplakia on a low-grade dysplastic lesion
(Figure-1). In the surveyed cases, 29.7% were benign, 2.7% were
dysplastic, and 43.2% were malignant.
Of the 37 lesions, 9 were classified as longitudinal and 28 as
perpendicular by the authors. The distribution of the pathological
lesions across the vascular patterns is shown in Table 1. The
pathological diagnoses of the lesions associated with longitudinal
vascular pattern were as follows: 8/9 were benign, as five polyps
(Figure-2), and three Reinke’s edema, and 1/9 was a low-grade dysplasia.
The pathological diagnoses of the lesions associated with perpendicular
vascular pattern were as follows: 16/28 were malignant, 9/28 were with
high-grade dysplasia (Figure-3) and 3/28 were benign. The distribution
of vascular patterns in benign, dysplastic and malignant conditions is
shown in Table 2. In the benign cases, the longitudinal pattern was
present in 72.7% and the perpendicular pattern was present in 27.3 %
of the lesions. In dysplastic and malignant lesions, the longitudinal
pattern was observed in 3.8% (Figure-4), whereas 96.2% presented with
perpendicular vascular pattern. The benign lesions with perpendicular
vascular patterns (Figure-4), included a granular cell tumor and another
two that were granulation tissue after laser cordectomy; the granulation
here was not associated with fibrin accumulation. In dysplastic and
malignant lesions, a low-grade dysplasia was evident with the
longitudinal vascular pattern. The relationship between the
vascularization pattern and the histopathological diagnosis was
statistically significant.
The sensitivity (SE) and specificity (SP) of Image1 S endoscopy were
96% (95% CI 80-99) and 72% (95% CI 39-93) respectively, for the
differentiation of malignant and dysplastic lesions from benign lesions.
The positive predictive value was 89% (95% CI 75-95) and the negative
predictive value was 88% (95% CI 53-98) with the accuracy rate 89%
(95% CI 74-96) (Table-2).