Verruciform Xanthoma: Immunohistochemical Characterization of Xanthoma Cell Phenotypes

Rawal, Swati Y.; Kalmar, John R.; Tatakis, Dimitris N.

doi:10.1902/jop.2007.060196

Cited by 29 publications

(31 citation statements)

References 30 publications

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“…It is considered to be a reactive process and majority are seen over the masticatory mucosa of the gingiva and hard palate as flat or slightly raised, papillary or warty, yellow-red lesions with a sharply demarcated border. The xanthoma cells are CD68 positive [17]. The xanthoma cells are S-100 negative but NKI/C3 and CD163 positive thereby highlighting their lysosomal content and their histiocytic lineage [18].…”

Section: Differential Diagnosismentioning

confidence: 91%

S-100 Negative Granular Cell Tumor (So-called Primitive Polypoid Non-neural Granular Cell Tumor) of the Oral Cavity

Rawal

Dodson

2016

Head and Neck Pathol

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Four cases of cutaneous S-100 negative granular cell tumor were described in 1991. Until now, only 3 cases of oral involvement have been documented in English literature. Two additional cases of oral S-100 negative granular cell tumor are described. Immunohistochemical markers were applied to exclude other lesions that may show the presence of granular cells. The clinical findings were correlated with the histopathological and immunohistochemical features to arrive at the appropriate diagnosis. S-100 negative granular cell tumors are erythematous polypoid masses commonly mistaken for granulation tissue or a pyogenic granuloma. Any part of the oral cavity may be affected. Histopathologically, the lesions consist of sheets, nests, and fascicles of granular cells that are S-100 negative. The granular cells are non-reactive to SMA, HMB45, Melan A, and CD163. The intracytoplasmic granules are diffusely and strongly positive to NKI/C3. The cell lineage of the S-100 negative granular cell tumor is obscure. Absence of staining with CD163 excludes a histiocytic lineage. Absence of staining with S-100 excludes a neural origin. Absence of staining with S-100 and key melanoma markers HMB45 and Melan A also excludes a melanocytic origin. In this context, positive reactivity with NKI/C3 is indicative of presence of intracytoplasmic lysosomal granules only. Greater awareness of this lesion in the oral cavity will result in better characterization of its biologic potential.

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Section: Differential Diagnosismentioning

confidence: 91%

S-100 Negative Granular Cell Tumor (So-called Primitive Polypoid Non-neural Granular Cell Tumor) of the Oral Cavity

Rawal

Dodson

2016

Head and Neck Pathol

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“…Philipsen et al 4 reported that the gum is the commonest site for verruciform xanthoma, followed by the palate in the 173 non-Japanese patients they studied, and 17 of these cases involved both the palate and the gum. Isolated palate involvement was also less frequent in the retrospective study of 16 cases conducted by Rawal et al 6 , who found only three palatine lesions. In a series of 15 cases, Yu et al 8 did not find any verruciform xanthoma in the palate but found one lesion in the palatine gingiva.…”

Section: Discussionmentioning

confidence: 85%

“…Sopena et al 5 described a case of disseminated verruciform xanthoma involving the hands, feet, genital region, ears, and palate. From the clinical point of view, verruciform xanthoma is characterized by a well delimited rough or papillary elevation and may be depressed or ulcerated at the center 4,[6][7] . Its color varies from pink, red, yellow, or brownish, to whitish or grey 4 .…”

Section: Introductionmentioning

confidence: 99%

“…The verrucous type presents acanthosis, hyperparakeratosis, and elongation of the rete ridges; the papillary type presents numerous finger-like projections containing connective tissue and parakeratin crypts; and the flat type presents subsurface epithelial proliferation [8][9] . Immunohistochemical studies show that xanthomatous cells are positive for CD68+, so they are considered cells of the macrophage lineage 4,6,14 .…”

Section: Introductionmentioning

confidence: 99%

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A rare case of giant verruciform xanthoma in the palate

Rosa

Amorim

2014

RGO, Rev. Gaúch. Odontol.

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RESUMOO xantoma verruciforme é uma lesão rara de etiologia não determinada, que acomete, principalmente, a mucosa oral. Na maioria das vezes é assintomática, caracterizando-se por uma elevação bem-delimitada, de superfície rugosa ou papilar, e sua principal localização na boca é a gengiva. Com relação ao tamanho, a maioria das lesões não ultrapassa 2 cm no seu maior diâmetro. O objetivo do presente trabalho é relatar um caso raro de extenso xantoma verruciforme em paciente do gênero masculino, de 55 anos, apresentando lesão localizada no palato duro e na gengiva palatina. Clinicamente, a lesão possuía bordas bem-destacadas, de superfície levemente granular e coloração avermelhada, com consistência elástica, medindo aproximadamente 2,8 X 1,5cm. O exame histopatológico demonstrou a presença de proliferação do epitélio de revestimento, exibindo papilomatose, paraceratose e alongamento das cristas epiteliais. Na lâmina própria, células xantomatosas com citoplasma claro e vacuolado puderam ser observadas. O paciente encontra-se livre de recidivas após 18 meses de acompanhamento clínico. De acordo com extensa pesquisa em bases de dados (pubmed, medline, lilacs), o presente caso representa uma das maiores lesões do tipo xantoma verruciforme já relatadas na literatura.Termos de indexação: Mucosa bucal. Palato. Patologia bucal. Xantomatose.

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“…It can be because of the damage to the squamous cells due to trauma, irritation, or infection, which can cause increased epithelial turnover leading to the disease. The epithelial breakdown leads to an inflammatory response and a subsequent release of lipid material from the degenerated cells [2,[8][9][10][11]. Most of the cases occur in otherwise healthy individuals.…”

Section: Discussionmentioning

confidence: 99%

Oral verruciform xanthoma: a case report and literature review

2012

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Verruciform xanthoma is a benign mucocutaneous, uncommon, nonsymptomatic lesion of uncertain etiopathology, which occurs mostly on the oral mucosa of middle-aged individuals. Histopathologically, VX is diagnosed by presence of lipid-laden foam cells in papillary region of connective tissue. A 60-year-old male patient presented with a painless growth on the left buccal mucosa. On clinical examination a yellowish white exophytic lesion, measuring 11 × 7 mm in size, was found, which was cauliflower-shaped on inspection and painless on palpation. Histopathological examination revealed varying degrees of surface parakeratosis and the accumulation of numerous foam cells in the connective tissue papillae among the uniformly elongated epithelial ridges. On immunohistochemical staining, there was a neutrophilic infiltrate of the epidermis with CD68 positive xanthoma cells restricted to the papillary dermis, mixed with other chronic inflammatory cells.

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Verruciform Xanthoma: Immunohistochemical Characterization of Xanthoma Cell Phenotypes

Abstract: 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.

Cited by 29 publications

References 30 publications

S-100 Negative Granular Cell Tumor (So-called Primitive Polypoid Non-neural Granular Cell Tumor) of the Oral Cavity

S-100 Negative Granular Cell Tumor (So-called Primitive Polypoid Non-neural Granular Cell Tumor) of the Oral Cavity

A rare case of giant verruciform xanthoma in the palate

Oral verruciform xanthoma: a case report and literature review

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