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KMID : 0829220120360020069
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Korean Journal of Oral and Maxillofacial Pathology
2012 Volume.36 No. 2 p.69 ~ p.76
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Differential Diagnosis of Papillary Papilloma, Verrucous Papilloma, and Inverted Papilloma from Oral Squamous Cell Papillomas
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Lee Sang-Shin
Kim Hyun-Ju
Park Seong-Yeon
Kim Yeon-Sook
Lee Suk-Keun
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Abstract
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Oral squamous cell papillomas(OSCPs) showed various features in their etiology, histology, and prognosis. Therefore, it is necessary to diagnose differentially according to their pathological examinations. In the present study total 14 cases of OSCPs were evaluated and characterized to be three types of OSCPs, i.e., papillary papilloma, verrucous papilloma, and inverted papilloma. The present study demonstrated that among 14 cases of OSCPs papillary papilloma (n＝6) showed the typical papillary projection of squamous epithelium with severe acanthosis of upper spinous layer cells, accompanying frequent nuclear vacuolization. And verrucous papilloma (n＝7) showed the diffuse acanthosis of whole spinous layer cells with severe basal hyperplasia, resulted in the thick squamous epithelium exhibiting verrucous surface and irregularly ingrowing rete pegs. One case of inverted papilloma showed the typical ingrowth of basal layer cells deeply into underlying connective tissue, resulted in the formation of multiple fissures on the surface area. The present study also revealed the predominant nuclear vacuolization suspicious for viral infection in papillary papilloma, and also heavy smoking history in the verrucous papilloma. On the other hand, as the epithelium of inverted papilloma ingrew into the underlying deep connective tissue up to the muscular layer, it is supposed that the inverted papilloma has a potential of basal layer proliferation strong enough to invade the protecting barrier of underlying connective tissue, or that the underlying connective tissue was too weak to prevent the ingrowth of basal layer epithelium. Taken together, because the OSCPs show heterogenous origins and variable pathological prognosis, it is suggested that the OSCPs should be differentially diagnosed at least into three types, i.e., papillary papilloma, verrucous papilloma, and inverted papilloma.
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KEYWORD
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Squamous Cell Papilloma, Differential Diagnosis, Acanthosis
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