2020. https://doi.org/10.1111/odi.13363. Occasionally, keratinizing SCC may occur.37,38, As a surrogate marker for high-risk HPV infection, p16 immunohistochemical stain serves as a helpful tool to distinguish warty, basaloid, and warty-basaloid squamous neoplasms from condyloma acuminatum and HPV-independent (differentiated) squamous neoplasms. Architectural Alterations in Oral Epithelial Dysplasia are - Springer Approximately 40% of warts in the genital area of young girls are VV (positive for HPV 2) while the rest are condylomas (positive for HPV 6 or 11).70 The clinical morphologies of VV and condyloma acuminatum are similar in that both are exophytic and verrucous papules, but VV tends to be more hyperkeratotic than condyloma acuminatum. The histopathologic features of epidermolytic acanthoma frequently raise suspicion for condyloma acuminatum or VV to the untrained eye. The disseminated form most frequently affects genital skin, particularly the scrotum and the vulva.7375 The lesions are skin-colored or whitish papules with a smooth or verruciform surface, frequently confused with condyloma acuminatum clinically.74,76 Multiple reports have confirmed the absence of HPV in epidermolytic acanthomas,73,76,77 although 1 reported case of scrotal epidermolytic acanthoma tested positive for HPV 16 when using a highly sensitive HPV DNA chip.78 It is possible that HPV was an incidental finding, rather than a pathogenic agent, in this isolated case. Amongst these are relatively rare entities such as bowenoid papulosis, epidermolytic acanthoma, and verruciform xanthoma, which are underrecognized by surgical pathologists. Papillary squamous cell carcinoma. Although a diagnostic hallmark of epidermolytic acanthoma, the EHK pattern is not specific for this diagnosis, as it may also be seen in epidermolytic ichthyosis,80 epidermolytic epidermal nevus,81,82 or as an incidental finding.83,84 These conditions are histologically indistinguishable, and clinical correlation is the key to correct diagnosis. Squamous B, Koilocytes are readily found in the upper epidermis, while the remaining keratinocytes are cytologically uniform and bland (hematoxylin-eosin, original magnifications 10 [A] and 200 [B]). Clinically, these are solitary or coalescent skin-colored papules with a papillomatous surface. Among these three types of clavicipitaceous endophytes are different interactions with their plant hosts. PubMed Background: Tongue squamous cell carcinoma (TSCC) is highly diverse, even in its early stages. Statistical analysis of inter-rater agreement was provided by Sijia Yue, MS at the University of Florida College of Public Health and Health Professions Department of Biostatistics. 2017;18(12):32514. Solitary epidermolytic acanthoma: a clinical and histopathological study, Inherited nonsyndromic ichthyoses: an update on pathophysiology, diagnosis and treatment, Histopathologic varieties of epidermal nevus: a study of 160 cases, Linear epidermolytic verrucous epidermal nevus of the male genitalia, Epidermolytic hyperkeratosis associated with melanocytic nevi: a report of 53 cases, Incidental cutaneous reaction patterns: epidermolytic hyperkeratosis, acantholytic dyskeratosis, and hailey-hailey-like acantholysis: a potential marker of premalignant skin change, Case of isolated epidermolytic acanthoma: Genetic and immunohistochemical analysis, Epidermolytic acanthoma of the genitalia does not show mutations in KRT1 or KRT10, Epidermolytic acanthomas: clinical characteristics and immunohistochemical features, Vegas (verruciform genital-associated) xanthoma: a comprehensive literature review, Vulvar verruciform xanthoma: ten cases associated with lichen sclerosus, lichen planus, or other conditions, Verruciform xanthoma of the penis: a rare benign lesion that simulates carcinoma, Verruciform xanthoma in an immunocompromised patient: a case report and immunohistochemical study, Characterization of verruciform xanthoma by in situ hybridization and immunohistochemistry, Cutaneous verruciform xanthoma: a report of five cases investigating the etiology and nature of xanthomatous cells, Verruciform xanthoma in the setting of cutaneous trauma and chronic inflammation: report of a patient and a brief review of the literature, Verruciform xanthoma: a clinical, light microscopic, and electron microscopic study of two cases, Kristine M. Cornejo, MD, Lloyd Hutchinson, PhD, Patrick O'Donnell, DO, Xiuling Meng, MD, Keith Tomaszewicz, BS, MT(ASCP), Sara C. Shalin, MD, PhD, David S. Cassarino, MD, May P. Chan, MD, Timothy R. Quinn, MD, Paul B. Googe, MD, Rosalynn M. Nazarian, MD, Ridhi Sood, MBBS, MD, Debajyoti Chatterjee, MBBS, MD, DM, Pinaki Dutta, MBBS, MD, DM, Bishan Dass Radotra, MBBS, MD, MAMS, PhD, Gurpal Bisra, MMOR, MSc, BASc, Brigette Rabel, MLT, Nick van der Westhuizen, MB, FRCPC, Jing Wang, MD, PhD, Yan Peng, MD, PhD, Hongxia Sun, MD, PhD, Phyu P. Aung, MD, PhD, Erika Resetkova, MD, PhD, Clinton Yam, MD, MS, Aysegul A. Sahin, MD, Lei Huo, MD, PhD, Qingqing Ding, MD, PhD, Abha Goyal, MD, Christine N. Booth, MD, Rhona J. Souers, MS, Sana O. Tabbara, MD, Janie Roberson, SCT(ASCP), Michael R. Henry, MD, Kaitlin E. Sundling, MD, PhD, Kelly Goodrich, CT(ASCP), Lananh Nguyen, MD, Mohammed Amer Swid, MD, Liping Li, MD, Erin M. Drahnak, BS, Hayden Idom, BS, William Quinones, MD, Jianhong Li, MD, Myra L. Wilkerson, MD, Fang-Ming Deng, MD, Haiyan Liu, MD, Adesola A. Akinyemi, MD, MPH, Ansa Mehreen, MD, Kathy A. Mangold, PhD, MaryAnn Regner, MS, John M. Lee, MD, PhD, Linda M. Ernst, MD, MHS, Si Chen, MMed, Zhigang Mao, MMed, Shuang Wang, MMed, Jiamin Deng, MMed, Hongyan Liao, PhD, Qin Zheng, PhD, Monica Sanchez-Avila, MD, Khalid Amin, MD, Aastha Chauhan, MD, Zhuo Geng, MD, Shawn Mallery, MD, Dale C. Snover, MD, This site uses cookies. Interobserver and intraobserver variability in the histologic assessment of oral lichen planus. [24] However, unique to this experiment was the mode by which this was thought to happen. official website and that any information you provide is encrypted Oral Surg Oral Med Oral Pathol Oral Radiol. Through association with fungal endophytes, the root and shoot structures of Pseudotsuga menziesii (Douglas-fir) saplings in low-nutrient conditions have been shown to be elongated, as well as undergo overall biomass increases. Shear M, Pindborg JJ. The eruption was Numerous tumors can develop in a short period of time. Capella DL, Gonalves JM, Abrantes AAA, Grando LJ, Daniel FI. An expert working group of oral and maxillofacial and head and neck pathologists reviewed microscopic features in a rigorous fashion, in combination with review of clinical photographs when available. Endophytic type squamous cell papilloma, is continuous with the adjacent hyperplastic epidermis and a crater forms by invagination with no pedicle. This endophytic type has neither invasive nor compressive growth into surrounding tissues. In this series, A, A warty squamous cell carcinoma shows an irregular verruciform architecture with conspicuous fibrovascular cores. [23], However, the specific biochemical mechanisms behind these behavioral changes are still largely unknown and lower-level signal cascades have yet to be discovered. B, Parakeratosis is compact with a characteristic orange hue or peach color. The https:// ensures that you are connecting to the Direct immunofluorescence testing results in cases of premalignant and malignant oral lesions. [64][65] Two fusarubin derivatives: anhydrofusarubin and methyl ether of fusarubin were isolated from endophytic fungus Cladosporium sp. Upadhyaya JD, Fitzpatrick SG, Cohen DM, et al. [24] Additionally, H. frisingense is known to produce indoleacetic acid (IAA),[25] and was also shown to manage IAA genes, indicating that there is an intricate balance maintained between ethylene and IAA by H. A Troubling Diagnosis of Verrucous Squamous Cell Carcinoma Cancer. [42] Class 3 endophytes are restricted to growth in above ground plant tissues and form in localized areas of plant tissue. 2016;17(9):4491. Careers. An endophyte is an endosymbiont, often a bacterium or fungus, that lives within a plant for Keratinocytes in the spinous layer are markedly enlarged with abundant eosinophilic cytoplasm and minimal nuclear atypia (Figure 3, B).25,28 Scattered dyskeratotic cells are common.24 An important diagnostic criterion is the absence of koilocytes, which distinguishes it from giant condyloma acuminatum. Epub 2016 Jun 14. This expert consensus guideline has been developed with support and endorsement from the leadership of the American Academy of Oral and Maxillofacial Pathology and the North American Society of Head and Neck Pathologists to recommend the use of standardized histopathologic criteria and descriptive terminology to indicate three categories of lesions within PVL: (1) corrugated ortho(para)hyperkeratotic lesion, not reactive; (2) bulky hyperkeratotic epithelial proliferation, not reactive; and (3) suspicious for, or squamous cell carcinoma. Classification of PVL lesions based on a combination of clinical findings and these histologic descriptive categories is encouraged in order to standardize reporting, aid in future research and potentially guide clinical management. Mignogna MD, Fortuna G, Leuci S, et al. [42], Non-clavicipitaceous endophytes represent a polyphyletic group of organisms. There are two different means of classifying endophytes. As a general rule, anogenital SK-like lesions with an undulating appearance (Figure 1, C), with or without pseudohorn cysts, are probably best treated as condyloma acuminatum, as opposed to those with a flat base.15, Pirog et al16,17 have found positive Ki-67 (MIB-1) immunostaining, defined as any cluster of at least 2 positive nuclei in the upper two-thirds of the epithelium, in all vulvar and anal condylomas examined, a finding that correlated well with positive HPV results by polymerase chain reaction (PCR) and DNA sequencing. While some authors believe that the 2 are either identical or closely related on a continuous spectrum, accumulating evidence suggests that these are distinct entities. Google Scholar. Unlike lesions infected with high-risk HPV, which are diffusely and strongly positive for p16, condylomas display negative, focal, or patchy staining (Figure 1, D).17,18 When necessary, testing for low-risk HPV (types 6 and 11) by PCR-DNA sequencing, in situ hybridization, or immunohistochemistry may also aid in diagnosis.19, Giant condyloma acuminatum is a large, fungating, and locally destructive form of condyloma acuminatum. Ancillary tools available for identifying and genotyping human papillomavirus can aid in diagnosis when histopathologic findings are inconclusive. This growth pattern indicates that fungal hyphae are substantially attached to the plant host's cell wall, but do not invade plant cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. PubMed and have shown cytotoxicity against human leukemia (K-562). Fibrovascular cores are thin and inconspicuous relative to the hypertrophic epithelium. [22] Improvements in water use efficiency were observed in higher CO2 concentrations and a further increase was seen in water deficit conditions. London: Wiley; 1981. eCollection 2019 Dec. Histopathologic features of multiple cutaneous squamous cell carcinomas of the lower extremity. This is a bulky squamous proliferation, three to four times the thickness of the epithelium for the site, that is endophytic and/or exophytic in its growth pattern [5], Most endophyte-plant relationships are still not well understood. - 213.202.212.252. Please enable it to take advantage of the complete set of features! Oral Oncol. Am J Dermatopathol. Keratosis of unknown significance and leukoplakia: a preliminary study. sharing sensitive information, make sure youre on a federal https://doi.org/10.1007/s12105-020-01262-9, DOI: https://doi.org/10.1007/s12105-020-01262-9. WebFollow-up ranged from 15 to 73 months. Med Oral Patol Oral Cir Bucal. Characterized by complex, confluent, back to back glandular proliferation, while oncocytic papilloma has a simple exophytic or endophytic growth pattern without architectural complexity High grade tumors may show marked nuclear atypia Nonkeratinizing squamous cell carcinoma: 2014;118(6):71324. [39] Non-systemic or transient endophytes on the other hand vary in number and diversity within their plant hosts under changing environmental conditions. A long-term study of thirty patients. Keratoacanthoma and infundibulocystic squamous cell carcinoma. Condyloma acuminatum. The endophytic type SCP can cause differential diagnostic difficulties with keratoacanthom WebSQUAMOUS CELL CARCINOMA In-situ - the second most common type of skin cancer caused from sun exposure, warts, or areas of old wounds. Benign alveolar ridge keratosis (oral lichen simplex chronicus): a distinct clinicopathologic entity. [1], Endophytes were first described by the German botanist Johann Heinrich Friedrich Link in 1809. World Workshop on Oral Medicine VII: Prognostic biomarkers in oral leukoplakia and proliferative verrucous leukoplakiaA systematic review of retrospective studies. [59] Three triterpenes were found in the endophyte Xylarialean sp., all three of these compounds displayed mild cytotoxic effects on tumor cells. Collectively, these feature give rise to a softer appearance compared to VV. [31] It is suggested that areas of high plant diversity such as tropical rainforests may also contain the highest diversity of endophytic organisms that possess novel and diverse chemical metabolites. Oral epithelial dysplasia and premalignancy. However, this view has been challenged by the frequent detection of HPV in giant condylomas but rarely in verrucous carcinomas.24,25 As in ordinary condyloma acuminatum, giant condylomas usually harbor HPV 6 and 11.24 Recurrence rate is high,21 and malignant transformation to invasive SCC has been reported in more than 50% of cases, most commonly in HIV-positive patients.20,21 Not surprisingly, coinfection with high-risk HPV has been demonstrated in carcinoma ex giant condyloma acuminatum.26, The microscopic features of giant condyloma acuminatum are similar to those of its ordinary counterpart except for its large size and more florid excrescences. Endophytic fungi produce many secondary compounds such as alkaloids, triterpenes and steroids which have been shown to have anti-tumor effects. [24], Endophytic species are very diverse; only a small minority of existing endophytes have been characterized. Before Mller S. Frictional keratosis, contact keratosis and smokeless tobacco keratosis: features of reactive white lesions of the oral mucosa. Cases were re-evaluated during a consensus conference with 19 members reporting on the cases. J Am Acad Dermatol. They typically colonize plant shoots where they form a systemic intercellular infection. Would you like email updates of new search results? J Oral Pathol Med. Br J Dermatol. have activity against strains of multi drug-resistant Mycobacterium tuberculosis. A, A typical papillomatous papule with only mild hyperkeratosis. 299biopsies from 84 PVL patients from six institutions were selected from patients who had multifocal oral leukoplakic lesions identified over several years (a minimum follow-up period of 36 months). [20] Specific endophyte species can also stimulate root growth by increasing the flux of auxin to where the endophyte is. This drug is important for the treatment of cancer. The basaloid tumor cells display high nuclear to cytoplasmic ratio and frequent mitoses at all levels of the epithelium (inset). Gillenwater AM, Vigneswaran N, Fatani H, Saintigny P, El-Naggar AK. [66] Also, compounds from the marine fungus Nigrospora sp. Karabulut A, Reibel J, Therkildsen MH, et al. There is marked papillomatosis with usually mild hyperkeratosis (Figure 2, A). Iocca O, Sollecito TP, Alawi F, et al. Oral Oncol. [72] Increasingly there has been great importance placed on endophytes that protect valuable crops from invasive insects. This site needs JavaScript to work properly. Oral Surg Oral Med Oral Pathol Oral Radiol. Figure 4Warty and warty-basaloid high-grade squamous intraepithelial lesion (HSIL) and squamous cell carcinoma. Oral Dis. Head Neck Pathol. The fungi cause the grasses to contain toxic alkaloids. 1997;84(2):1547. Oral Surg Oral Med Oral Pathol Oral Radiol. [32] It has been estimated that there could be approximately 1 million endophytic fungi that exist in the world. Inter-observer variability in the diagnosis of proliferative verrucous leukoplakia: clinical implications for oral and maxillofacial surgeon understanding: a collaborative pilot study. [39] Systemic endophytes are defined as organisms that live within plant tissues for the entirety of its life cycle and participate in a symbiotic relationship without causing disease or harm to the plant at any point. [43][44][45][46][47][48][49] Use of endophytes might potentially increase crop yields. SEBASTIAN, SHELDON; Multiple studies have shown that unlike giant condylomas, which consistently harbor HPV, anogenital verrucous carcinomas diagnosed on the basis of strict histopathologic criteria (see below) are predominantly negative for HPV.24,25,2830 These findings support distinct pathogenetic pathways in verrucous carcinoma and giant condyloma acuminatum, and that they should be considered separate entities. 1985;60(3):28598. B, Koilocytosis and cytologic atypia are readily appreciated in this warty squamous cell carcinoma. Feller L, Wood NH, Raubenheimer EJ. Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue Woodland Hills, CA, 91364, Woodland Hills, USA, Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, USA, Sarah G. Fitzpatrick,Indraneel Bhattacharyya,Mohammed N. Islam&Donald M. Cohen, Atlanta Oral Pathology, Emory University School of Medicine, Decatur, GA, USA, Oral Health and Diagnostic Sciences, University of Connecticut Health, Farmington, CT, USA, Section of Diagnostic Sciences, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, IL, USA, Department of Pathology, University of Chicago Medicine, Chicago, IL, USA, Department of Diagnostic and Biomedical Sciences, University of Texas School of Dentistry at Houston, Houston, TX, USA, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA, Department of Diagnostic Sciences, University of Pittsburgh School of Dental Medicine, Pittsburgh, PA, USA, Centro Clnico de Cabeza y Cuello, Patologa Divisin, Guatemala City, Guatemala, Department of Pathology, Immunology and Laboratory Medicine, University of Florida College of Medicine, Gainesville, FL, USA, Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA, Department of Pathology & Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA, Department of Pathology, Inova Fairfax Hospital, Falls Church, VA, USA, Department of Pathology, University of Ottawa, Ottawa, Ontario, Canada, Department of Pathology, MUSC Health-University Medical Center, Charleston, SC, USA, Department of Pathology, Moffitt Cancer Center, Tampa, FL, USA, You can also search for this author in
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