Difference between revisions of "Squamous papilloma"

Squamous papilloma
	Diagnosis in short
	; Squamous papilloma. H&E stain.
Synonyms	squamous cell papilloma
LM	branching papillae (papilla = nipple-like projection with a fibrovascular core), basal cell hyperplasia, koilocytes
LM DDx	squamous cell carcinoma of the head and neck (esp. verrucous, papillary and exophytic subtypes), verruca vulgaris, oral condyloma
Site	head and neck
Prevalence	common
Prognosis	benign
Treatment	excision

Latest revision as of 03:52, 22 July 2014

Squamous papilloma, also squamous cell papilloma, is a benign squamous lesion, typically of the head and neck.

Laryngeal papilloma redirects here.

The caruncle lesion is dealt with in papilloma of the caruncle. The lesion in the esophagus is dealt with in squamous papilloma of the esophagus.

General

Benign.
Typically related to HPV 6 and HPV 11.

Gross

Features:^[1]

Exophytic mass.

Microscopic

Features:^[1]

Branching papillae.
- Papilla = nipple-like projection with a fibrovascular core.
Basal cell hyperplasia.
Koilocytes.

Note:

The threshold for dysplasia is somewhat higher in the head and neck than in the uterine cervix.

DDx:

Squamous cell carcinoma of the head and neck - verrucous, papillary and exophytic subtypes.
Verruca vulgaris - have granular layer, hyperkeratosis and parakeratosis.^[2]
Oral condyloma - broader projections with a blunted appearance.^[2]

Images

SP - very low mag.
SP - low mag.
SP - low mag.
SP - intermed. mag.
SP - high mag.

www:

Sign out

LARYNGEAL LESION ("LARYNGEAL PAPILLOMA"), RIGHT, BIOPSY:
- SQUAMOUS PAPILLOMA.

Not definite

TONGUE PAPULE, RIGHT, BIOPSY:
- SQUAMOUS EPITHELIUM WITH PARAKERATOSIS AND VERY SCANT STROMA WITH FEATURES
SUGGESTIVE OF A SQUAMOUS PAPILLOMA.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.

Dysplastic

LARYNGEAL LESION ("LARYNGEAL PAPILLOMA"), LEFT, BIOPSY:
- SQUAMOUS PAPILLOMA WITH LOW-GRADE DYSPLASIA.
- NEGATIVE FOR HIGH-GRADE DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
- CLOSE FOLLOW-UP IS RECOMMENDED.

Micro

The sections show fibrovascular cores covered by stratified squamous epithelium with basal cell hyperplasia and edema. Scattered lymphocytes are present in the epithelium. No mitotic activity is appreciated. There is no significant nuclear atypia. Dyskeratotic cells are seen focally. Parakeratosis is present. Koilocytes are not apparent.

Low-grade dysplasia

The sections show fibrovascular cores covered by stratified squamous epithelium. Scattered lymphocytes are present in the epithelium. Rare mitotic activity is appreciated in the lower third of the epithelium. Mild nuclear atypia (hyperchromasia and mild nuclear enlargement in the lower third of the epithelium) is present. Dyskeratotic cells are seen focally. Parakeratosis is present. Koilocytes are seen focally.

References

↑ ^1.0 ^1.1 Thompson, Lester D. R. (2006). Head and Neck Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 33. ISBN 978-0443069604.
↑ ^2.0 ^2.1 Thompson, Lester D. R. (2006). Head and Neck Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 426. ISBN 978-0443069604.
↑ Hedström, J.; Grenman, R.; Ramsay, H.; Finne, P.; Lundin, J.; Haglund, C.; Alfthan, H.; Stenman, UH. (Oct 1999). "Concentration of free hCGbeta subunit in serum as a prognostic marker for squamous-cell carcinoma of the oral cavity and oropharynx.". Int J Cancer 84 (5): 525-8. PMID 10502732.

[Ref_HaNP33-1] 1.0 ^1.1 Thompson, Lester D. R. (2006). Head and Neck Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 33. ISBN 978-0443069604.

[Ref_HaNP246-2] 2.0 ^2.1 Thompson, Lester D. R. (2006). Head and Neck Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 426. ISBN 978-0443069604.

[pmid10502732-3] Hedström, J.; Grenman, R.; Ramsay, H.; Finne, P.; Lundin, J.; Haglund, C.; Alfthan, H.; Stenman, UH. (Oct 1999). "Concentration of free hCGbeta subunit in serum as a prognostic marker for squamous-cell carcinoma of the oral cavity and oropharynx.". Int J Cancer 84 (5): 525-8. PMID 10502732.

[1]

[2]

[3]

@@ Line 1: / Line 1: @@
-#redirect [[Head_and_neck_pathology#Squamous_papilloma]]
+{{ Infobox diagnosis
+| Name       = {{PAGENAME}}
+| Image      = Squamous papilloma -- very low mag.jpg
+| Width      =
+| Caption    = Squamous papilloma. [[H&E stain]].
+| Synonyms   = squamous cell papilloma
+| Micro      = branching papillae (papilla = nipple-like projection with a fibrovascular core), basal cell hyperplasia, koilocytes
+| Subtypes   =
+| LMDDx      = [[squamous cell carcinoma of the head and neck]] (esp. verrucous, papillary and exophytic subtypes), [[verruca vulgaris]], [[oral condyloma]]
+| Stains     =
+| IHC        =
+| EM         =
+| Molecular  =
+| IF         =
+| Gross      =
+| Grossing   =
+| Site       = [[head and neck pathology|head and neck]]
+| Assdx      =
+| Syndromes  =
+| Clinicalhx =
+| Signs      =
+| Symptoms   =
+| Prevalence = common
+| Bloodwork  =
+| Rads       =
+| Endoscopy  =
+| Prognosis  = benign
+| Other      =
+| ClinDDx    =
+| Tx         = excision
+}}
+'''Squamous papilloma''', also '''squamous cell papilloma''', is a benign squamous lesion, typically of the [[Head and neck pathology|head and neck]].
+''Laryngeal papilloma'' redirects here.
+The caruncle lesion is dealt with in ''[[papilloma of the caruncle]]''. The lesion in the [[esophagus]] is dealt with in ''[[squamous papilloma of the esophagus]]''.
+==General==
+*Benign.
+*Typically related to [[HPV]] 6 and HPV 11.
+==Gross==
+Features:<ref name=Ref_HaNP33>{{Ref HaNP|33}}</ref>
+*Exophytic mass.
+==Microscopic==
+Features:<ref name=Ref_HaNP33>{{Ref HaNP|33}}</ref>
+*Branching papillae.
+**Papilla = nipple-like projection with a fibrovascular core.
+*Basal cell hyperplasia.
+*Koilocytes.
+Note:
+*The threshold for dysplasia is somewhat higher in the [[head and neck pathology|head and neck]] than in the [[uterine cervix]].
+DDx:
+*[[Squamous cell carcinoma of the head and neck]] - verrucous, papillary and exophytic subtypes.
+*[[Verruca vulgaris]] - have granular layer, hyperkeratosis and parakeratosis.<ref name=Ref_HaNP246>{{Ref HaNP|426}}</ref>
+*[[Oral condyloma]] - broader projections with a blunted appearance.<ref name=Ref_HaNP246>{{Ref HaNP|426}}</ref>
+===Images===
+<gallery>
+Image: Squamous papilloma -- very low mag.jpg | SP - very low mag.
+Image: Squamous papilloma -- low mag.jpg | SP - low mag.
+Image: Squamous papilloma - alt -- low mag.jpg | SP - low mag.
+Image: Squamous papilloma -- intermed mag.jpg | SP - intermed. mag.
+Image: Squamous papilloma -- high mag.jpg | SP - high mag.
+</gallery>
+www:
+*[http://www.webpathology.com/image.asp?case=170&n=1 Laryngeal papilloma - low mag. (webpathology.com)].
+*[http://www.webpathology.com/image.asp?case=170&n=2 Laryngeal papilloma - high mag. (webpathology.com)].
+*[http://ars.els-cdn.com/content/image/1-s2.0-S1875918111001450-gr2a.jpg Low-grade squamous dysplasia (els-cdn.com)].<ref name=pmid10502732>{{Cite journal  | last1 = Hedström | first1 = J. | last2 = Grenman | first2 = R. | last3 = Ramsay | first3 = H. | last4 = Finne | first4 = P. | last5 = Lundin | first5 = J. | last6 = Haglund | first6 = C. | last7 = Alfthan | first7 = H. | last8 = Stenman | first8 = UH. | title = Concentration of free hCGbeta subunit in serum as a prognostic marker for squamous-cell carcinoma of the oral cavity and oropharynx. | journal = Int J Cancer | volume = 84 | issue = 5 | pages = 525-8 | month = Oct | year = 1999 | doi =  | PMID = 10502732 | URL = http://www.sciencedirect.com/science/article/pii/S1875918111001450 }}</ref>
+==Sign out==
+<pre>
+LARYNGEAL LESION ("LARYNGEAL PAPILLOMA"), RIGHT, BIOPSY:
+- SQUAMOUS PAPILLOMA.
+</pre>
+===Not definite===
+<pre>
+TONGUE PAPULE, RIGHT, BIOPSY:
+- SQUAMOUS EPITHELIUM WITH PARAKERATOSIS AND VERY SCANT STROMA WITH FEATURES
+SUGGESTIVE OF A SQUAMOUS PAPILLOMA.
+- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
+</pre>
+===Dysplastic===
+<pre>
+LARYNGEAL LESION ("LARYNGEAL PAPILLOMA"), LEFT, BIOPSY:
+- SQUAMOUS PAPILLOMA WITH LOW-GRADE DYSPLASIA.
+- NEGATIVE FOR HIGH-GRADE DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
+- CLOSE FOLLOW-UP IS RECOMMENDED.
+</pre>
+===Micro===
+The sections show fibrovascular cores covered by stratified squamous epithelium with basal cell hyperplasia and edema.  Scattered lymphocytes are present in the epithelium.  No mitotic activity is appreciated.  There is no significant nuclear atypia.
+Dyskeratotic cells are seen focally. Parakeratosis is present. Koilocytes are not apparent.
+====Low-grade dysplasia====
+The sections show fibrovascular cores covered by stratified squamous epithelium.  Scattered lymphocytes are present in the epithelium.  Rare mitotic activity is appreciated in the lower third of the epithelium.  Mild nuclear atypia (hyperchromasia and mild nuclear enlargement in the lower third of the epithelium) is present.
+Dyskeratotic cells are seen focally. Parakeratosis is present. Koilocytes are seen focally.
+==See also==
+*[[Head and neck pathology]].
+*[[Mixed squamous cell and glandular papilloma of the lung]].
+==References==
+{{Reflist|2}}
 [[Category:Diagnosis]]
+[[Category:Head and neck pathology]]