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

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.

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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.

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