J Am Acad Dermatol. van der Meij EH, Reibel J, Slootweg PJ, et al. [28] One group of fungal endophytes are the arbuscular mycorrhizal fungi involving biotrophic Glomeromycota associated with various plant species. 2015;9(7):Zc17-22. 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. Epub 2016 Jun 14. : A clinicopathologic comparison of 2,153 lesions. Case 2. The objective of this study was to produce an expert consensus guideline for standardized assessment and reporting by pathologists diagnosing PVL related lesions. This is a small series. [5], Most endophyte-plant relationships are still not well understood. Bulky squamous epithelial proliferation with an exophytic and/or endophytic growth pattern (the former often associated with corrugated/verrucous/papillary architecture). The eruption was initially treated with topical 5-FU twice daily for 4 weeks to treat his large hyperkeratotic lesions on the lower legs that were concerning for multifocal eruptive squamous atypia Interobserver and intraobserver variability in the histologic assessment of oral lichen planus. [21], Additionally, various reports on endophyte interactions have shown increased photosynthetic capacities of host plants as well as improved water relations. Histopathologically, VV is characterized by marked verruciform acanthosis and hyperkeratosis. Learn more about Institutional subscriptions. Squamous cell-like skin proliferations: Differential diagnosis Main differential diagnoses and their characteristics: [1] Invasive squamous-cell carcinoma of This drug is important for the treatment of cancer. Mod Pathol. This growth pattern indicates that fungal hyphae are substantially attached to the plant host's cell wall, but do not invade plant cells. The working group then selected 43 single slide biopsy cases for whole slide digital imaging (WSI) review by members of the consensus conference. Verrucous carcinoma of the oral cavity. 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. Both condyloma acuminatum and VV are caused by low-risk HPV. CAS 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. J Oral Pathol Med. These features should prompt a closer inspection for xanthomatous (foam) cells, which are confined to the dermal papillae (Figure 9, C). There are two different means of classifying endophytes. Microscopically, the lesion showed proliferation of the well-differentiated stratified squamous epithelium, forming endophytic complex branching networks interconnected with multiple deep keratin-filled clefts and crypts. Downward epithelial proliferation for at least three times the normal thickness of the epithelium was considered bulky endophytic proliferation. Direct immunofluorescence testing results in cases of premalignant and malignant oral lesions. The endophytic type SCP can cause differential diagnostic difficulties with keratoacanthom Head Neck. Cases associated with high-grade intraepithelial neoplasia and warty/basaloid squamous cell carcinoma (SCC) are coinfected with high-risk HPV types.68. The constellation of marked hyperkeratosis, spiky papillae, and convergence of elongated rete ridges allows for distinction of VV from condyloma acuminatum. Head and Neck Pathology Unauthorized use of these marks is strictly prohibited. [11][12], Endophytes may benefit host plants by preventing other pathogenic or parasitic organisms from colonizing them. 2013;18(3):e4113. Epub 2011 Dec 15. In contrast, basaloid HSIL is characterized by a flat surface and minimal maturation from the basal layer to the granular layer. Current agriculture relies heavily on fungicides and high levels of chemical fertilizers. [57][58] Endophyte bioprospecting has already yielded compounds with antibacterial,[59][60] antifungal,[61] antiviral,[61] antiparasitic,[62] cytotoxic,[59][63] neuroprotective,[62] antioxidant,[62] insulin-mimetic,[62] -glucosidase inhibitory,[61] and immunosuppressant[62] properties. 2016;17(9):4491. Demonstration of HPV 2 or other nongenital HPV types in the absence of HPV 6 or 11, either by in situ hybridization or by PCR-DNA sequencing, would support a diagnosis of VV and exclude condyloma acuminatum.6872. Proliferative verrucous leukoplakia: unusual locations of oral squamous cell carcinomas, and field cancerization as shown by the appearance of multiple OSCCs. 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 B RSA, Hegde NP, et al. Subject: Verruciform and Condyloma-like Squamous Proliferations in the Anogenital Region, (Optional message may have a maximum of 1000 characters.). CAS 2017;18(12):32514. The ragged tumor base is indicative of stromal invasion. Provided by the Springer Nature SharedIt content-sharing initiative, Over 10 million scientific documents at your fingertips, Not logged in The tumor base is round and noninfiltrative. Oral Oncol. Careers. Background: C, A defining feature is the presence of xanthomatous (foam) cells in the dermal papillae (hematoxylin-eosin, original magnifications 40 [A], 200 [B], and 400 [C]). WebSQUAMOUS CELL CARCINOMA In-situ - the second most common type of skin cancer caused from sun exposure, warts, or areas of old wounds. A, An exophytic and endophytic verrucous squamous proliferation with a bulbous, pushing base. The site is secure. The large tumor mass compresses but does not infiltrate normal structures. Clin Exp Dermatol. eCollection 2019 Dec. Histopathologic features of multiple cutaneous squamous cell carcinomas of the lower extremity. [59] Several isolates from the ascomycota Pestalotiopsis sp. Numerous tumors can develop in a short period of time. The eruption was Histopathologic analysis showed 16 of the 30 lesions did not have prominent cytologic atypia and were distinguished by having expanded follicle-like structures composed of large, glassy, eosinophilic keratinocytes; these lesions resembled keratoacanthoma and were categorized as keratoacanthoma-like squamous proliferations (KASPs). MeSH Mller S. Oral lichenoid lesions: distinguishing the benign from the deadly. Woo SB, Grammer RL, Lerman MA. 2018;24(5):74960. Oral mucosal lesions associated with smokers and chewersa casecontrol study in chennai population. Inoculation saw an upregulation in the genes relevant to jasmonate and ethylene production in the plant roots, although the mechanism to this is still unknown. Marginal linear gingival leukoplakia progressing to ring around the collaran ominous sign of proliferative verrucous leukoplakia. 2014;117(4):51120. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. J Am Dent Assoc. Shear M, Pindborg JJ. An official website of the United States government. Correspondence to 1999;28(6):2747. Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype. The rest of the keratinocytes appear normal. Correct diagnosis of condyloma acuminatum and condyloma-like lesions has important clinical implication and entails familiarization with their clinical presentations and histopathologic features. Differentiated intraepithelial neoplasia and lichen sclerosus may be found in the adjacent epithelium.37,51. Potentially malignant disorders of the oral and oropharyngeal mucosa; terminology, classification and present concepts of management. [30], One or more endophytic organisms are found in nearly every land plant. Search for other works by this author on: Systematic review of the incidence and prevalence of genital warts, Evidence of human papillomavirus vaccine effectiveness in reducing genital warts: an analysis of California public family planning administrative claims data, 2007-2010, Early impact of Ontario's human papillomavirus (HPV) vaccination program on anogenital warts (AGWs): a population-based assessment, Decline in genital warts diagnoses among young women and young men since the introduction of the bivalent HPV (16/18) vaccination programme in England: an ecological analysis, Correlation of human papillomavirus types with clinical features of patients with condyloma acuminatum in China, Coexisting high-grade vulvar intraepithelial neoplasia (VIN) and condyloma acuminatum: independent lesions due to different HPV types occurring in immunocompromised patients, Coexistence of condylomata acuminata with warty squamous cell carcinoma and squamous cell carcinoma, Human papillomavirus (HPV) genotypes in condylomas, intraepithelial neoplasia, and invasive carcinoma of the penis using laser capture microdissection (LCM)-PCR: a study of 191 lesions in 43 patients, Correlation of histology and human papillomavirus DNA detection in condyloma acuminatum and condyloma-like vulvar lesions, Seborrheic keratoses from the genital region may contain human papillomavirus DNA, Detection of human papillomavirus DNA in seborrheic keratosis by polymerase chain reaction, Immunophenotypic and viral (human papillomavirus) correlates of vulvar seborrheic keratosis, Genital seborrheic keratoses are human papillomavirus-related lesions: a linear array genotyping test study. Google Scholar. B, Large spinous keratinocytes contain abundant eosinophilic cytoplasm and bland nuclei. [59] The alkaloid beauvericin has been isolated from the fungus Fusarium oxysporum and has shown cytotoxicity against the tumor cells PC3, PANC-1, and A549. and transmitted securely. An incisional biopsy specimen (measuring 1.5 1 cm down to bone) was obtained for histopathological examination. 1. Cabay RJ, Morton TH Jr, Epstein JB. 2015;19(2):198204. Although VV (common wart) usually occurs on extragenital skin, it can occasionally arise in the anogenital area and may result in diagnostic confusion with condyloma acuminatum. which was first harvested from the plant Bontia daphnoides. Oral Surg Oral Med Oral Pathol Oral Radiol. 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. [39] An example of this would be Colletotrichum fioriniae, which is an endophyte of many temperate broadleaved trees and shrubs, but can also be a pathogen on many fruits and some leaves.[40][41]. Given its papillomatous architecture and large size, many regarded giant condyloma acuminatum as a variant of verrucous carcinoma. [72] Increasingly there has been great importance placed on endophytes that protect valuable crops from invasive insects. The deeper dermis is remarkable for an inflammatory infiltrate and ectatic vessels. WebAtypical squamous proliferation: what lies beneath? [42] These four groups are divided into clavicipitaceous endophytes (Class 1) and non-clavicipitaceous endophytes (Class 2, 3, and 4). B, Koilocytosis and cytologic atypia are readily appreciated in this warty squamous cell carcinoma. Proliferative verrucous leukoplakia and field cancerization: report of a case. Keratoacanthoma, committed stem cells and neoplastic aberrant infundibulogenesis integral to formulating a conceptual model for an infundibulocystic pathway to squamous cell carcinoma. [42], Endophytes may have potential future applications in agriculture. 2019;215(12):152670. Upadhyaya JD, Fitzpatrick SG, Cohen DM, et al. [23], However, the specific biochemical mechanisms behind these behavioral changes are still largely unknown and lower-level signal cascades have yet to be discovered. 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. Bookshelf Fleiss JL. Cancer. [62], A well known example of the discovery of chemicals derived from endophytic fungi is from the fungus Taxomyces andreanae isolated from the pacific yew Taxus brevifolia. [42] Many non-clavicipitaceous endophytes have the ability to switch between endophytic behavior and free-living lifestyles. Reproducibility of grading systems in oral epithelial dysplasia. PubMed The endophytes can survive most pesticides and are even resistant to some fungicides, and are very suitable for use in Integrated Pest Management. Head Neck Pathol. Koilocytosis may be subtle but often can be appreciated in a background of hypergranulosis. Connolly M, Narayan S, Oxley J, de Berker DA. A few koilocytes are present in the granular layer (hematoxylin-eosin, original magnifications 20 [A] and 200 [B]). NCI CPTC Antibody Characterization Program. T. andreanae produces paclitaxel, also known as taxol. 2016;20(2):2618. Manchanda A, Shetty DC. 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). A, A small verrucous papule with marked hyperkeratosis. Figure 6Bowenoid papulosis. 2009 Aug;26(3):150-63. doi: 10.1053/j.semdp.2009.09.003. This article reviews the clinicopathologic features and etiopathogenesis of condyloma acuminatum and its mimics, with an emphasis on their morphologic similarities and unique characteristics that help in their distinction.
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endophytic squamous proliferation
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