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Head and Neck Pathology Mar 2022The fifth chapter of the upcoming fifth edition of the 2022 World Health Organization Classification of Tumours of the Head and Neck titled Tumours of the oral cavity... (Review)
Review
The fifth chapter of the upcoming fifth edition of the 2022 World Health Organization Classification of Tumours of the Head and Neck titled Tumours of the oral cavity and mobile tongue, has had some modifications from the 2017 fourth edition. A new section "Non-neoplastic Lesions", introduces two new entries: necrotizing sialometaplasia and melanoacanthoma. The combined Oral potentially malignant disorders and Oral epithelial dysplasia section in the 2015 WHO has now been separated and submucous fibrosis and HPV-associated dysplasia are also discussed in separate sections. Carcinoma cuniculatum and verrucous carcinoma are described in dedicated sections, reflecting that the oral cavity is the most common location in the head and neck for both these entities which have distinct clinical and histologic features from conventional squamous cell carcinoma. This review summarizes the changes in Chapter 5 with special reference to new additions, deletions, and sections that reflect current clinical, histological, and molecular advances.
Topics: Acanthoma; Carcinoma, Verrucous; Humans; Mouth Neoplasms; Oral Submucous Fibrosis; Sialometaplasia, Necrotizing; Tongue; Tongue Neoplasms; World Health Organization
PubMed: 35312982
DOI: 10.1007/s12105-021-01402-9 -
Journal Der Deutschen Dermatologischen... Jan 2021Clear cell acanthoma is a rarely diagnosed tumor with variable clinical morphology that is usually only recognized by its histopathological features. The primary lesion... (Review)
Review
Clear cell acanthoma is a rarely diagnosed tumor with variable clinical morphology that is usually only recognized by its histopathological features. The primary lesion is a red papule a few millimeters in diameter that often occurs as a single lesion on the lower extremities. In dermoscopy, resemblance of the vessels to a string of pearls is a largely specific finding of clear cell acanthoma. In contrast to the initially uncharacteristic clinical findings, histopathology of clear cell acanthomas is characterized by a typical compact, well-demarcated acanthosis consisting of pale-staining, PAS-reactive keratinocytes. As etiology and pathogenesis are both unclear, nosology of clear cell acanthoma is also controversial, with an ongoing debate as to its classification as cutaneous neoplasia or reactive inflammatory dermatosis.
Topics: Acanthoma; Dermoscopy; Humans; Keratinocytes; Keratosis; Skin Neoplasms
PubMed: 32989899
DOI: 10.1111/ddg.14270 -
Journal of the European Academy of... Apr 2022
Topics: Acanthoma; Humans; Nail Diseases; Skin Neoplasms
PubMed: 34753213
DOI: 10.1111/jdv.17800 -
The American Journal of Dermatopathology Jul 2021Eosinophilic hyaline inclusions (EHIs) or globules have been reported in various cutaneous tumors including vascular lesions, myoepithelial neoplasms, and basal cell...
Eosinophilic hyaline inclusions (EHIs) or globules have been reported in various cutaneous tumors including vascular lesions, myoepithelial neoplasms, and basal cell carcinoma. In basal cell carcinoma, the presence of intracytoplasmic inclusions is reportedly associated with myoepithelial differentiation. In this regard, EHI has not been conclusively documented in a cutaneous lesion of genuine squamous cell lineage without aberrant differentiation. In the current case, a biopsy from the right thigh of a 71-year-old male patient demonstrated a relatively well-demarcated intraepidermal squamous lesion featured an admixture of predominantly enlarged keratinocytes harboring distinct eccentric intracytoplasmic EHI and a smaller population of keratinocytes displaying pale cytoplasm. Cytologic atypia, mitotic activity, and inflammatory cells were not identified. The intracytoplasmic EHI stained red with Masson's trichrome and were negative with periodic-acid Schiff with and without diastase. Immunologically, the lesion was strongly and diffusely positive for various cytokeratins but negative for ubiquitin and myoepithelial markers. Only cytokeratin AE1 revealed a differential staining pattern as the suprabasal lesional cells displayed significantly stronger immunoreactivity in comparison with the adjacent normal keratinocytes. Polymerase chain reaction for low-risk and high-risk human papillomavirus was negative. Molecular studies did not reveal any mutations commonly encountered in seborrheic or lichenoid keratoses. As an analogous lesion has not previously reported in the literature, the term hyaline inclusion acanthoma is proposed for this peculiar lesion.
Topics: Acanthoma; Aged; Biomarkers, Tumor; Biopsy; Humans; Hyalin; Immunohistochemistry; Keratinocytes; Male; Skin Neoplasms
PubMed: 33606370
DOI: 10.1097/DAD.0000000000001927 -
Archives of Pathology & Laboratory... Jul 2019Histologic distinction between condyloma acuminatum and various benign and malignant condyloma-like lesions in the anogenital area poses a common diagnostic challenge to... (Review)
Review
CONTEXT.—
Histologic distinction between condyloma acuminatum and various benign and malignant condyloma-like lesions in the anogenital area poses a common diagnostic challenge to pathologists across subspecialties.
OBJECTIVE.—
To review the overlapping and distinguishing features of condyloma acuminatum and its mimics, and to clarify confusing terminology and diagnostic criteria for problematic entities.
DATA SOURCES.—
A review of the literature on condyloma acuminatum (ordinary and giant types), verrucous carcinoma, warty/warty-basaloid high-grade squamous intraepithelial lesion and squamous cell carcinoma, papillary squamous cell carcinoma, bowenoid papulosis, verruca vulgaris, epidermolytic acanthoma, and verruciform xanthoma was performed.
CONCLUSIONS.—
Correct diagnosis of condyloma acuminatum and condyloma-like lesions has important clinical implication and entails familiarization with their clinical presentations and histopathologic features. Contrary to historical belief, giant condyloma acuminatum and verrucous carcinoma should be considered distinct entities based on different pathogenetic pathways. Ancillary tools available for identifying and genotyping human papillomavirus can aid in diagnosis when histopathologic findings are inconclusive. Recognition of relatively rare entities such as bowenoid papulosis, epidermolytic acanthoma, and verruciform xanthoma would avoid overdiagnosis and unnecessary, overaggressive treatment.
Topics: Condylomata Acuminata; Female; Genital Diseases, Female; Genital Diseases, Male; Humans; Male; Rectal Diseases
PubMed: 30203987
DOI: 10.5858/arpa.2018-0039-RA -
The American Journal of Dermatopathology Dec 2021Various acanthomas have been named based on their distinctive histopathologic patterns. Hypergranulotic dyskeratotic acanthoma represents another acanthoma with a...
Various acanthomas have been named based on their distinctive histopathologic patterns. Hypergranulotic dyskeratotic acanthoma represents another acanthoma with a distinctive histopathologic pattern that has been rarely reported. In this article, clinical and histological features of hypergranulotic dyskeratotic acanthoma are delineated. A retrospective analysis was performed of cases with diagnosis or suggested diagnosis of hypergranulotic dyskeratotic acanthoma between 2012 and 2017 from 2 dermatopathology laboratories. Forty-eight potentials were identified, of which 18 cases met the inclusion histologic criteria. Most cases came from women (78%) with a mean age of 53 years, and the thigh was the most common site involved. All cases had the following histopathological findings: (1) verrucous or digitated epidermal hyperplasia, (2) hyperkeratosis dominated by basketweave or compact orthokeratosis, (3) hypergranulosis involving the breadth of the lesion, and (4) presence of enlarged, often indistinctly bordered, keratinocytes with cytoplasm characterized by a blue-gray granular peripheral zone sometimes showing outstretched desmosomes and central perinuclear eosinophilic zones, a combination of findings representing slowly evolving dyskeratosis. Retrospective nature and a small sample size are the major limitations of the study. In sum, hypergranulotic dyskeratotic acanthoma can be easily distinguished from other acanthomas based on their repeatable histopathological findings.
Topics: Acanthoma; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Retrospective Studies; Skin Neoplasms
PubMed: 33958516
DOI: 10.1097/DAD.0000000000001966 -
Journal of Clinical Medicine Apr 2024Clear cell acanthoma (CCA) and squamous cell carcinoma (SCC) represent distinct entities within dermatological oncology, each posing unique diagnostic and therapeutic... (Review)
Review
Clear cell acanthoma (CCA) and squamous cell carcinoma (SCC) represent distinct entities within dermatological oncology, each posing unique diagnostic and therapeutic challenges. CCA is a rare, benign epidermal growth, often not associated with human papillomavirus (HPV) infection, whereas SCC, a more aggressive form of skin cancer, has been linked to both ultraviolet (UV) exposure and HPV. Understanding the co-occurrence of these conditions in a single patient can enhance diagnostic accuracy and therapeutic outcomes. We report a 64-year-old male who underwent an operation for a verruciform lesion in the right groin, which was diagnosed as HPV-positive CCA alongside keratinised SCC. A literature search across January 2024 revealed limited evidence directly linking HPV to CCA, suggesting a need for further investigation. The speculative association between HPV and CCA warrants deeper exploration, especially considering the potential for HPV to contribute to lesion development through indirect mechanisms. The coexistence of CCA and SCC in an elderly patient presents a unique clinical scenario. This emphasises the need for vigilant diagnosis and tailored treatment strategies, highlighting the gap in understanding the pathogenesis of CCA, particularly its potential association with HPV. Further research is crucial for elucidating the complex interactions governing these conditions and for developing targeted interventions.
PubMed: 38731009
DOI: 10.3390/jcm13092482