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Ocular Oncology and Pathology Aug 2019Large cell acanthoma (LCA) was first described as a lesion on sun-exposed skin. All LCAs feature keratinocytes twice the size of normal cells (cytomegaly). Although...
Large cell acanthoma (LCA) was first described as a lesion on sun-exposed skin. All LCAs feature keratinocytes twice the size of normal cells (cytomegaly). Although infrequently diagnosed in the skin, it has been even more rarely described by ophthalmic pathologists in the eyelid skin and the conjunctiva. This report describes the third case of a conjunctival epithelial LCA, with the first published clinical photograph highlighting its leukoplakic and well-circumscribed character, as well as the most thorough analysis of the immunohistochemical features of this lesion. It is contrasted with squamous dysplasias and papillomas of the conjunctiva. A review of previous conjunctival LCA lesions discloses frequent recurrences after initial surgery and the remote but real potential for squamous dysplastic transformation. Immunohistochemical stains for certain cytokeratins, p53, and Ki-67 (proliferation index) will in the future be particularly helpful in establishing an early and accurate diagnosis of conjunctival LCA.
PubMed: 31559241
DOI: 10.1159/000495250 -
Head and Neck Pathology Jun 2020Clear cell acanthoma (CCA), also known as pale cell acanthoma, represents a rare benign epidermal tumor with strong predilection for the lower extremities of middle-aged...
Clear cell acanthoma (CCA), also known as pale cell acanthoma, represents a rare benign epidermal tumor with strong predilection for the lower extremities of middle-aged individuals and no frank gender preference. The etiology of CCA is poorly understood, although a localized psoriasiform reaction is favored. Herein, we report on the clinicopathologic and immunohistochemical features, and HPV status of an apparent example of oral CCA. A 58-year-old female presented with a well-circumscribed, asymptomatic, exophytic, sessile and erythematous nodule of the right hard palate, measuring 0.7 cm in greatest dimension. Microscopically, the lesion featured parakeratosis and acanthosis with neutrophilic microabscesses and broad elongated rete pegs. In areas, spinous epithelial cells exhibited pale or clear cytoplasm without nuclear pleomorphism, mitoses or cytologic atypia. The supporting connective tissue revealed mild chronic inflammation with few scattered neutrophils and numerous capillary vessels. PAS histochemical stain with and without diastase disclosed the presence of cytoplasmic glycogen in the pale cells. The majority of glycogen-rich epithelial cells stained strongly for EMA and were negative for D2-40. Ki-67 immunostaining was confined only to the basal cell layer of the epithelium. A diagnosis of CCA was rendered. The lesion was negative for human papillomavirus (HPV) infection, as assessed by HPV-DNA PCR using the MY09/11 primers for the L1 conserved region, thus HPV infection does not appear to contribute to the pathogenesis of oral CCA. In conclusion, we report an intraoral example of CCA in order to raise awareness about this entity.
Topics: Acanthoma; Female; Humans; Middle Aged; Palatal Neoplasms; Palate, Hard; Skin Neoplasms
PubMed: 31230231
DOI: 10.1007/s12105-019-01050-0 -
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