Lingual subgemmal neurogenous plaques with pseudoepitheliomatous hyperplasia: Incidental pseudomalignant condition

Abstract

Pseudoepitheliomatous hyperplasia is a reactive proliferation of benign squamous epithelium that can mimic squamous cell carcinoma. Herein is a report on this type of reaction on two subgemmal neurogenous plaques in a lingual circumvallate papilla. To the authors' knowledge this is the first report on this combination of lesions. A 66-year-old man died with disseminated squamous cell carcinoma of the lung. At autopsy the tongue was found to have an incidental pseudoepitheliomatous hyperplasia on two subgemmal neurogenous plaques with ganglion cells. Subgemmal neurogenous plaque should be included in the differential diagnosis of causes of lingual pseudoepitheliomatous hyperplasia. Awareness of the morphological spectrum of subgemmal neurogenous plaques can avoid the overdiagnosis of these lesions as neural tumors or squamous cell carcinoma.

Subgemmal neurogenous plaque associated with burning tongue: report of two cases and review of the literature

“…Subgemmal neurogenous plaques (SNPs) are microscopically characterized as subepithelial aggregates of ganglion cells and nerve plexus usually associated with taste buds of the tongue. Normally no clinical sign is observed, but occasionally this entity is associated with an erythematous area, ulcer, a white patch and a hyperplastic papule 4,9,10 . Oral burning symptoms have been associated with various possible etiologies, including fungal infections, vitamin deficiencies, drug side effects, oral allergies, hormonal disturbances, psychosocial stressors, diabetes, dry mouth, galvanism, parafunctional habits, cranial nerve injuries and also idiopathic causes 5 .…”

“…Oral burning symptoms have been associated with various possible etiologies, including fungal infections, vitamin deficiencies, drug side effects, oral allergies, hormonal disturbances, psychosocial stressors, diabetes, dry mouth, galvanism, parafunctional habits, cranial nerve injuries and also idiopathic causes 5 . All these conditions may present a clinical diagnostic challenge, and consequently an inadequate treatment may be performed if they are not fully recognized 2,10 .…”

Oral plexiform schwannoma with unusual epithelial induction

“…With the exception of a notorious granular cell tumor, inductive hyperplasia of the epidermis or adnexal epithelium is less well documented in otherwise typical dermal nerve sheath tumors . Traumatic or palisaded encapsulated neuroma, common or Spitz nevus, malignant melanoma, and subgemmal neurogenous plaque are oral mucosal examples.…”

Histomorphometric characterization of subgemmal neurogenous plaques

“…Associated clinical symptoms and signals, such as burning sensation, erythema, ulcers, white patches, and hyperplastic nodule, are uncommon. 2,3 Because the clinical and histopathologic features of SNPs can vary from patient to patient, their structure may represent a diagnostic challenge for clinicians and pathologists, 2 occasionally leading to misdiagnosis. 3,4 Only 2 other previous small case series describe the morphologic features of SNPs.…”

“…2,3 Because the clinical and histopathologic features of SNPs can vary from patient to patient, their structure may represent a diagnostic challenge for clinicians and pathologists, 2 occasionally leading to misdiagnosis. 3,4 Only 2 other previous small case series describe the morphologic features of SNPs. McDaniel 1 performed a histomorphologic study on 12 SNPs and described the relationship between SNPs and taste buds, the diameter of SNPs, and the mean number of ganglion cells.…”