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Gannepalli A, Appala A, Reddy L, Babu DBG. Insight into verruciform xanthoma with oral submucous fibrosis: Case report and review of literature. J Oral Maxillofac Pathol 2019; 23:43-48. [PMID: 30967723 PMCID: PMC6421923 DOI: 10.4103/jomfp.jomfp_210_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Verruciform xanthoma (VX) is a rare benign mucocutaneous verrucopapillary lesion, which mainly involves masticatory mucosa and gingiva. Clinically, it presents as a solitary, sessile or pedunculated, white- or yellow-white-colored growth with a pebbled surface, hence often misdiagnosed as papilloma. The hallmark of histological diagnosis is the presence of foam cells or xanthoma cells confined to the connective tissue papillae. We present a case of VX on the maxillary gingiva in a 52-year-old male patient with oral submucous fibrosis (OSF) with a review on histopathology and concomitant oral lesions. The exact etiopathogenesis is not clearly delineated more so when it is associated with diverse local and systemic conditions. Its concomitant association with other conditions such as lichen planus, leukoplakia, oral squamous cell carcinoma and OSF is rare, with only three cases of VX associated with OSF reported earlier.
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Affiliation(s)
- Ashalata Gannepalli
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
| | - Amruta Appala
- Department of Oral and Maxillofacial Pathology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
| | - Lavanya Reddy
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
| | - Dara Balaji Gandhi Babu
- Department of Oral Medicine and Radiology, Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Dilsukhnagar, Hyderabad, Telangana, India
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Tamiolakis P, Theofilou VI, Tosios KI, Sklavounou-Andrikopoulou A. Oral verruciform xanthoma: Report of 13 new cases and review of the literature. Med Oral Patol Oral Cir Bucal 2018; 23:e429-e435. [PMID: 29924759 PMCID: PMC6051686 DOI: 10.4317/medoral.22342] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 05/05/2018] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Oral verruciform xanthoma (OVX) is a rare lesion. The purpose of the present study is to describe the clinical features of 13 OVXs and review all cases reported in the English literature. MATERIAL AND METHODS Thirteen cases of OVX diagnosed during a 47-year period were retrospectively collected. The patients gender and age, as well as the main clinical features of the lesions were retrieved from the biopsy request forms. Pubmed, Scopus and Google ScholarTM electronic databases were searched with the key word verruciform xanthoma. Only cases of histologically confirmed OVX were included in the study. RESULTS The 13 OVXs represented approximately 0.04% of 35,617 biopsies accessioned during the study period. They affected 13 patients, 8 males and 5 females with a mean age of 48.8±14 years. They mainly appeared as asymptomatic granular nodules or plaques, with elastic or normal consistency and white color, in the gingiva or hard palate. Literature review yielded 416 cases of OVX. With the addition of cases of the present study, 429 cases of OVX have been presented in the English literature. OVX has a slight male predominance with a male to female ratio of 1.4:1 and the majority of patients are in the 5th to 7th decade of life. Clinically, OVX mainly presents as an asymptomatic, single, papillary or granular plaque or nodule, with elastic or soft consistency and white, red or pink color. It measures approximately 1cm and is most commonly located on the gingiva, tongue, hard palate or buccal mucosa. The treatment of choice is surgical excision with little rates of recurrence. CONCLUSIONS Verruciform xanthoma is a rare lesion most often encountered on the ginigival mucosa. As its clinical presentation is not pathognomonic, it should be included in the differential diagnosis of verrucous or papillary lesions.
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Affiliation(s)
- P Tamiolakis
- Department of Oral Medicine and Oral Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece, 2 Thivon Str, 11527, Goudi, Athens, Greece,
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de Andrade BAB, Agostini M, Pires FR, Rumayor A, Carlos R, de Almeida OP, Romañach MJ. Oral verruciform xanthoma: a clinicopathologic and immunohistochemical study of 20 cases. J Cutan Pathol 2015; 42:489-95. [PMID: 25930961 DOI: 10.1111/cup.12500] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 04/05/2015] [Accepted: 04/18/2015] [Indexed: 01/02/2023]
Abstract
Verruciform xanthoma of the oral cavity is an uncommon benign lesion that usually affects the palate and gingiva mainly as a well-circumscribed solitary yellowish to whitish plaque or nodule, which is promptly recognized microscopically by identification of sub-epithelial foamy macrophages. The aim of this study was to evaluate the clinicopathologic and immunohistochemical features of 20 cases of oral verruciform xanthoma. All cases were evaluated by conventional hematoxylin/eosin staining and six of those were submitted to immunohistochemical reactions for CD68, CD63, CD163, syndecan-1 (CD138), S-100 protein and cytokeratins (CK) 8, 14 and 19. Oral verruciform xanthoma presented as yellowish papillary nodules affecting mainly the palate (30%), buccal mucosa (30%) and gingiva (25%) of middle-aged male patients. Most cases presented papillary epithelial hyperplasia and sub-epithelial foamy cells, which were immunopositive for CD68, CD63 and CD163 in all cases. The orange parakeratin superficial layer was negative for CK14 and presented a distinct granular membrane pattern of positivity for CD138. S-100 protein, CK8, and CK19 were negative.
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Affiliation(s)
- Bruno A B de Andrade
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Michelle Agostini
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Fábio R Pires
- Oral Pathology, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Alicia Rumayor
- Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (FOP-UNICAMP), Piracicaba, Brazil
| | - Román Carlos
- Pathology Section, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala
| | - Oslei P de Almeida
- Oral Pathology, School of Dentistry, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil
| | - Mário J Romañach
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
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Aggarwal S, Aggarwal A, Gill S, Bakshi Y, Singh HP. Verruciform xanthoma of oral cavity- a case report. J Clin Diagn Res 2014; 8:FD11-2. [PMID: 25177573 DOI: 10.7860/jcdr/2014/8822.4590] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 06/06/2014] [Indexed: 11/24/2022]
Abstract
Verruciform xanthoma is an uncommon benign lesion of undetermined aetiology. It is a superficial normo-lipemic xanthoma, probably reflecting a multifactorial reactive and dystrophic process. Its clinical and pathological recognition and correct diagnosis is critical because it can occur in conjunction with other systemic and cutaneous inflammatory diseases; therefore, it necessitates further clinical assessment. We, hereby report a rare case of verruciform xanthoma in 46-year-old male patient with history of leukemia with emphasis on need of vigilant comprehensive analysis of clinicopathological and immunohistohemical finding to arrive at definitive diagnosis and for better understanding of pathogenesis.
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Affiliation(s)
- Shivani Aggarwal
- Professor & Head, Department of Oral and Maxillofacial Pathology, Manav Rachna Dental College , Faridabad, Haryana, India
| | - Ashim Aggarwal
- Professor & Head, Department of Oral Surgery, Manav Rachna Dental College , Faridabad, Haryana, India
| | - Sharanjeet Gill
- Senior Lecturer, Department of Oral Pathology & Microbiology, Manav Rachna Dental College , Faridabad, Haryana, India
| | - Yujika Bakshi
- Senior Lecturer, Department of Prosthodontics, DJ Dental College , Uttar Pradesh, India
| | - Harkanwal Preet Singh
- Senior Lecturer, Department of Oral Pathology & Microbiology, Dasmesh Institute of Research and Dental Sciences , Faridkot,India
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Hegde U, Doddawad VG, Sreeshyla H, Patil R. Verruciform xanthoma: A view on the concepts of its etiopathogenesis. J Oral Maxillofac Pathol 2014; 17:392-6. [PMID: 24574658 PMCID: PMC3927341 DOI: 10.4103/0973-029x.125205] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Verruciform xanthoma is a very uncommon papillary growth seen chiefly in the oral mucosa. The presence of foam cells in the connective tissue papillae between the epithelial rete ridges forms the hallmark in its diagnosis. There has been wide speculation and various hypotheses put forth in explaining the etiopathogenesis of verruciform xanthoma and the origin of foam cells. This article aims to update the different hypotheses in understanding the pathogenesis of the lesion.
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Affiliation(s)
- Usha Hegde
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
| | - Vidya G Doddawad
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
| | - Hs Sreeshyla
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
| | - Rekha Patil
- Department of Oral Pathology and Microbiology, Jagadguru Sri Shivarathreeshwara Dental College and Hospital (A Constituent College of Jagadguru Sri Shivarathreeshwara University), Mysore, Karnataka, India
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6
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Woo SB. Diseases of the oral mucosa. MCKEE'S PATHOLOGY OF THE SKIN 2012:362-436. [DOI: 10.1016/b978-1-4160-5649-2.00011-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Shahrabi Farahani S, Treister NS, Khan Z, Woo SB. Oral verruciform xanthoma associated with chronic graft-versus-host disease: a report of five cases and a review of the literature. Head Neck Pathol 2011; 5:193-8. [PMID: 21305367 PMCID: PMC3098333 DOI: 10.1007/s12105-011-0246-2] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 01/27/2011] [Indexed: 12/18/2022]
Abstract
Verruciform xanthoma (VX) is an uncommon benign inflammatory mucocutaneous condition that chiefly occurs in the oral cavity. It is often associated with pre-existing epithelial and/or inflammatory disorder and is characterized histopathologically by papillary epithelial hyperplasia and the presence of foamy macrophages in connective tissue papillae. We report of a series of five cases with VX who concurrently had chronic oral graft-versus-host disease following hematopoietic stem cell transplantation.
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Yu CH, Tsai TC, Wang JT, Liu BY, Wang YP, Sun A, Chiang CP. Oral verruciform xanthoma: a clinicopathologic study of 15 cases. J Formos Med Assoc 2007; 106:141-7. [PMID: 17339158 DOI: 10.1016/s0929-6646(09)60230-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND/PURPOSE Oral verruciform xanthoma (VX) is an uncommon oral mucosal lesion. This retrospective study evaluated the clinical and histopathologic features of 15 oral VXs occurring in Taiwanese patients. METHODS Fifteen consecutive cases of oral VX were collected from January 1988 to December 2005. Clinical data and microscopic features of these cases were reviewed and analyzed. RESULTS The mean age of patients was 45 years (range, 18-79 years). There were eight male and seven female patients. Seven (46.6%) cases occurred on the gingiva, four (26.7%) on the tongue, and four (26.7%) on the buccal or vestibular mucosa. The greatest mean dimension of the lesions was 0.8 cm (range, 0.3-2.0 cm). Three patients had concomitant other oral mucosal lesions such as oral submucous fibrosis, squamous cell carcinoma, and erosive oral lichen planus. Microscopically, all specimens showed varying degrees of surface parakeratosis and the accumulation of numerous foam cells in the connective tissue papillae among uniformly elongated epithelial ridges. Individuals or aggregates of foam cells were also found underneath the epithelial ridges in nine (60%) cases. When the oral VX lesions were further classified into three types according to the microscopic surface architecture, seven (47%) lesions were of the verrucous type, three (20%) the papillary type, and five (33%) the flat type. All patients received surgical excision of the lesions and no recurrence was noted during follow-up of up to 18 years. CONCLUSION Oral VXs occur more frequently in the fifth decade of life. The more commonly affected site is the gingiva. The treatment of choice for oral VXs is surgical excision. The prognosis is excellent and recurrence was not seen in this study.
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Affiliation(s)
- Chuan-Hang Yu
- Graduate Institute of Clinical Dentistry and School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan
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9
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Rawal SY, Kalmar JR, Tatakis DN. Verruciform xanthoma: immunohistochemical characterization of xanthoma cell phenotypes. J Periodontol 2007; 78:504-9. [PMID: 17335374 DOI: 10.1902/jop.2007.060196] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Verruciform xanthoma (VX) is a benign lesion that primarily affects the oral cavity, most frequently the gingiva. VX lesions are characterized by xanthoma cells (lipid-laden macrophages or foam cells) found in the superficial connective tissue. To characterize these foam cells further, immunohistochemical techniques were used to investigate the presence of macrophage subpopulations in oral lesions of VX. METHODS Sixteen biopsy samples of VX lesions from the oral cavity (six from gingiva, three from palate, and seven from other mucosa) were studied. Immunohistochemical analysis was performed using antibody probes to macrophage subpopulations, including RM3/1 (reparative), 25F9 (resident), and 27E10 (inflammatory). The percentage of antibody-labeled foam cells was determined by visual counts of selected fields within lesional connective tissue. RESULTS The proportion of VX lesions that demonstrated positive xanthoma cell reactivity with antibodies RM3/1, 25F9, and 27E10 was 100%, 88%, and 50%, respectively. Foam cells that stained positively with RM3/1, 25F9, and 27E10 represented 61.5% +/- 19.6%, 51.8% +/- 29.4%, and 10.9% +/- 14.7% of the counted cells, respectively. When results were analyzed based on anatomic location (gingiva, palate, and other mucosa), there was no difference in the percentage of positively stained cells by anatomic site for any of the three antibodies (P >0.05). Similarly, there were no differences between masticatory (gingiva and palate) and other mucosa (P >0.05). CONCLUSIONS VX lesions contain primarily reparative and resident foam cells, with limited numbers of inflammatory macrophages, consistent with a chronic reactive process. These findings were independent of the anatomic site.
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Affiliation(s)
- Swati Y Rawal
- Department of Periodontology, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN 38163, USA.
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10
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Abstract
Verruciform xanthoma is xanthomatous dermal infiltrate in a proliferating epidermal lesion and is an uncommon phenomenon. It has been reported in various neoplastic or inflammatory conditions. We report a 72-year-old man who had an asymptomatic 1-cm black nodule on his abdomen. Histopathology showed a typical acanthotic type of seborrheic keratosis characterized by basaloid keratinocyte proliferation and pseudohorn cysts. Many aggregated xanthomatized cells were seen in dermal papillae within the acanthotic epithelium. Papillomatosis, parakeratosis, and neutrophil infiltrates, the histologic features of typical verruciform xanthoma, were not seen. The foamy cells were positive for CD-68 and vimentin and negative for cytokeratin and S-100. No human papillomavirus DNA was found by nested polymerase chain reaction. The blood lipid profile was normal. The presence of verruciform xanthomatous change in seborrheic keratosis provides further evidence that verruciform xanthoma may be a reactive phenomenon occurring in common skin disorders.
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Affiliation(s)
- Yu-Hung Wu
- Department of Dermatology, Mackay Memorial Hospital, Taipei, Taiwan
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11
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Ravasi T, Hsu K, Goyette J, Schroder K, Yang Z, Rahimi F, Miranda LP, Alewood PF, Hume DA, Geczy C. Probing the S100 protein family through genomic and functional analysis. Genomics 2004; 84:10-22. [PMID: 15203200 DOI: 10.1016/j.ygeno.2004.02.002] [Citation(s) in RCA: 119] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2003] [Revised: 01/21/2004] [Accepted: 02/02/2004] [Indexed: 11/30/2022]
Abstract
The EF-hand superfamily of calcium binding proteins includes the S100, calcium binding protein, and troponin subfamilies. This study represents a genome, structure, and expression analysis of the S100 protein family, in mouse, human, and rat. We confirm the high level of conservation between mammalian sequences but show that four members, including S100A12, are present only in the human genome. We describe three new members of the S100 family in the three species and their locations within the S100 genomic clusters and propose a revised nomenclature and phylogenetic relationship between members of the EF-hand superfamily. Two of the three new genes were induced in bone-marrow-derived macrophages activated with bacterial lipopolysaccharide, suggesting a role in inflammation. Normal human and murine tissue distribution profiles indicate that some members of the family are expressed in a specific manner, whereas others are more ubiquitous. Structure-function analysis of the chemotactic properties of murine S100A8 and human S100A12, particularly within the active hinge domain, suggests that the human protein is the functional homolog of the murine protein. Strong similarities between the promoter regions of human S100A12 and murine S100A8 support this possibility. This study provides insights into the possible processes of evolution of the EF-hand protein superfamily. Evolution of the S100 proteins appears to have occurred in a modular fashion, also seen in other protein families such as the C2H2-type zinc-finger family.
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Affiliation(s)
- Timothy Ravasi
- SRC for Functional and Applied Genomics, University of Queensland, Brisbabe, OLD, Australia.
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Philipsen HP, Reichart PA, Takata T, Ogawa I. Verruciform xanthoma--biological profile of 282 oral lesions based on a literature survey with nine new cases from Japan. Oral Oncol 2003; 39:325-36. [PMID: 12676251 DOI: 10.1016/s1368-8375(02)00088-x] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The biological profile of oral verruciform xanthoma (VX) is presented based on a world-wide literature survey of 282 cases. From 1979 onwards, extraoral cases have also been reported. This rare, harmless lesion with a sessile or pedunculated base is a red/pink, papillary/granular/verrucous mucosal growth, occurring in females (mean age, 54.9 yrs) and males (mean age, 44.2 yrs) in a female:male ratio of 1:1.1. The most common location is by far the gingival margin and other areas of the masticatory oral mucosa. Comparison between 173 non-Japanese and 109 Japanese patients with oral VX showed few discrepancies in epidemiological data, indicating only few significant ethnic differences between the two cohorts. Histomorphologically, the epithelium covering the lesion can be divided into three groups: (A) a verrucous, (B) a papillary and (C) a flat pattern. The hallmark of all VX, irrespective of the lesion being intra- or extraoral is, however, the presence of vacuolated, foam or xanthoma cells which ultimately replace the connective tissue between the epithelial ridges. The xanthoma cells have been shown to be cells of the monocyte/macrophage lineage. The present concept of the etiology and pathogenesis of VX, including the possible viral (HPV) association is revised, based on both intra- and some extraoral cases, and it is concluded that it is still far from being clarified.
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Affiliation(s)
- H P Philipsen
- Edificio El Cóndor 30, Guadalmina Alta, San Pedro de Alcántara, Spain
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13
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Polonowita AD, Firth NA, Rich AM. Verruciform xanthoma and concomitant lichen planus of the oral mucosa. Int J Oral Maxillofac Surg 1999. [DOI: 10.1016/s0901-5027(99)80682-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Iamaroon A, Vickers RA. Characterization of verruciform xanthoma by in situ hybridization and immunohistochemistry. J Oral Pathol Med 1996; 25:395-400. [PMID: 8890055 DOI: 10.1111/j.1600-0714.1996.tb00285.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Verruciform xanthoma (VX) is a rare, benign lesion, mainly found in the oral mucosa. Histologically and ultrastructurally, the lesion is characteristic and well defined. However, the etiology of the lesion remains unclear. The purpose of the present study was to elaborate upon the pathogenesis of VX by evaluation of an additional series of oral examples for human papillomaviruses (HPV), using immunohistochemistry and in situ hybridization, and to further characterize the cellular components of VX immunohistochemically. Twelve specimens diagnosed as VX were retrospectively collected. One of the twelve specimens was positive for HPV types 6/11 by in situ hybridization. None of the twelve specimens demonstrated the presence of HPV antigen by immunohistochemistry. By immunohistochemical studies, the predominant cells in the inflammatory infiltrate were T cells. The foam cells were of monocyte/macrophage lineage. S-100-positive (Langerhans) cells were occasionally found in the suprabasal layer of the epithelium. HLA-DR-positive keratinocytes were noted at the intense inflammatory sites. Taken together, these findings suggest that an immune response may play a role, at least in part, in VX pathogenesis.
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Affiliation(s)
- A Iamaroon
- Department of Clinical Dental Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada
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15
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Huang JS, Tseng CC, Jin YT, Huang CC, Wong TY, Chen HA, Chen HR, Kuo MY, Kuo YS. Verruciform xanthoma. Case report and literature review. J Periodontol 1996; 67:162-5. [PMID: 8667137 DOI: 10.1902/jop.1996.67.2.162] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Verruciform xanthoma is a relatively uncommon lesion. Half of the reported cases occurred in the gingiva or alveolar ridge. In most cases, the clinical impressions are papilloma or verrucous carcinoma, which demonstrates the importance of the clinical and pathological recognition of this lesion. The cause of pathogenesis is still unknown since the first report in 1971. There are some cases reported in conjunction with leukoplakia, carcinoma in situ, pemphigus, and discoid lupus erythematosus (DLE), which merits close evaluation of this disease. This article reports two cases of verruciform xanthoma and reviews the evidence of its pathogenesis from the available literature.
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Affiliation(s)
- J S Huang
- National Cheng-Kung University Hospital, Taiwan, ROC
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16
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Requena L, Sarasa JL, Martin L, Pique E, Farina MC, Olivares M, Escalonilla P. Verruciform xanthoma of the penis with acantholytic cells. Clin Exp Dermatol 1995; 20:504-8. [PMID: 8857349 DOI: 10.1111/j.1365-2230.1995.tb01390.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Verucciform xanthoma is an unusual lesion characterized by verrucous epithelial proliferation accompanied by a prominent replacement of the dermal papillae with foamy histiocytes. We describe a case of verruciform xanthoma on the glans penis. The most striking histopathological finding was the presence of numerous acantholytic cells in the upper layers of the epithelium. We discuss the differential diagnosis with other acantholytic disorders of the genital area and conclude that our findings can be interpreted as an additional example of incidental acantholysis.
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Affiliation(s)
- L Requena
- Department of Dermatology, Universidad Autonoma, Madrid, Spain
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17
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Mostafa KA, Takata T, Ogawa I, Ijuhin N, Nikai H. Verruciform xanthoma of the oral mucosa: a clinicopathological study with immunohistochemical findings relating to pathogenesis. VIRCHOWS ARCHIV. A, PATHOLOGICAL ANATOMY AND HISTOPATHOLOGY 1993; 423:243-8. [PMID: 8236821 DOI: 10.1007/bf01606886] [Citation(s) in RCA: 53] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Verruciform xanthoma is an uncommon benign lesion with unknown aetiology and pathogenesis. In this study, we report ten cases of verruciform xanthoma and document their clinical and histopathological findings. An immunohistochemical investigation was performed using antibodies to macrophage, leukocyte common antigen, T lymphocytes, B lymphocytes, S-100 protein, lysozyme and alpha-1-antichymotrypsin. Our results were similar to the other reported cases. Eighty percent of our cases were found on the gingiva. Candidal hyphae were found in the superficial parakeratotic layers in five cases. The clinical diagnosis of the lesion ranged between papilloma and squamous cell carcinoma. It is important for clinicians to take into consideration the possibility of verruciform xanthoma in the differential diagnosis of papillary and granular lesions of oral mucosa. Immunohistochemically, all foam cells were strongly stained with antimacrophage antibodies. T lymphocytes were the predominant infiltrating lymphocytes in the lesion. Langerhans cells in the epithelia were fewer than those in corresponding normal tissue. Our immunohistochemical findings suggest that verruciform xanthoma is may be a local immunological disorder, with a cell mediated mechanism.
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Affiliation(s)
- K A Mostafa
- Department of Oral Pathology, Hiroshima University School of Dentistry, Japan
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18
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Lombardi T, Hauser C, Budtz-Jörgensen E. Langerhans cells: structure, function and role in oral pathological conditions. J Oral Pathol Med 1993; 22:193-202. [PMID: 8315598 DOI: 10.1111/j.1600-0714.1993.tb01056.x] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Langerhans cells (LCs) are dendritic bone marrow derived cells situated suprabasally in most stratified squamous epithelia, such as the epidermis and the epithelium of oral mucosa, including the gingiva. Langerhans cells are thought to act as antigen-presenting cells (APC) during induction of immune responses. The exact role of Langerhans cells in the oral mucosa is not fully understood although several investigations suggest that these cells are involved in reactions to antigen challenge under both normal and pathological situations. In this paper the structure, phenotypic markers and derivation of Langerhans cells are reviewed. In view of recent findings, the immunological characteristics and the implications of Langerhans cells in pathologic oral reactions are discussed.
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Affiliation(s)
- T Lombardi
- Division of Gerodontology and Removable Prosthodontics, University of Geneva, Switzerland
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Affiliation(s)
- R L Snider
- Department of Dermatology, Medical University of South Carolina, Charleston 29425-2215
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Kakarantza-Angelopoulou E, Nicolatou O, Anagnostopoulou S. Verruciform xanthoma of the palate: case report with electron microscopy. J Oral Maxillofac Surg 1991; 49:409-12. [PMID: 2005497 DOI: 10.1016/0278-2391(91)90381-u] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Harsanyi BB, Larsson A. Xanthomatous lesions of the mandible: osseous expression of non-X histiocytosis and benign fibrous histiocytoma. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1988; 65:551-66. [PMID: 2836774 DOI: 10.1016/0030-4220(88)90138-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Seven cases of xanthomatous lesions of the mandible, followed from 1 to 18 years, are documented. All lesions were benign and painless; radiographic appearances varied from single and well-demarcated to diffuse and multilocular. Microscopic examination showed sheets of histiocytes with xanthoma or foam cells, fibroblasts and fibrous tissue, and inflammatory cells as well as cells in transition, with characteristics of both histiocytes and fibroblasts. Immunohistochemical staining and electron microscopic observation provided further evidence of the biphasic nature of this cell population. Twelve similar cases were found in the literature under a variety of diagnostic or descriptive labels. Our findings show that these lesions are histiocytic in nature and that they range from small, innocuous lesions, which we regard as the osseous counterpart of non-X histiocytosis, to larger, more destructive lesions diagnosed as benign fibrous histiocytoma (fibrous xanthoma) of bone.
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Affiliation(s)
- B B Harsanyi
- Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada
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