The utility of histopathology in identifying structural differences among layers of the lamina propria.

OBJECTIVE The purpose of this study is to assess the modality of laryngeal histopathology in identifying 1, 2, or 3 layers in the lamina propria. METHODS Blinded analysis was performed, with a set of histophathologic slides where the magnification and localized regions shown were all standardized. Two senior pathologists with experience reviewing laryngologic histophathology were asked to assess whether the vocal fold lamina propria they evaluated contained 1, 2, or 3 layers. Their ability to accurately assess this was calculated. RESULTS The first pathologist correctly identified 13 of 25 (52%) specimens. The second identified 19 of 25 (76%) specimens after receiving gold referents before the test. No significant difference was seen between the pathologists' interpretations (McNemar test; p = 0.0833). CONCLUSION Our results show the difficulty of using histopathology to distinguish layers in the lamina propria even when the reviewers are senior pathologists. These findings imply that more objective modalities for such analyses may be beneficial.