.

1. Squamous Papilloma/
(Oral Wart)
Verruciform xanthoma
Verruca-Papillary Lesions

2. Contents
Clinical feature
Etiology and
Pathogenesis
Histopathology
Differential
Diagnosis

3. Squamous
Papilloma
(Oral Wart)
• Oral squamous papilloma is a generic
term that used to include papillary and
verrucous growths composed of benign
epithelium and minor amounts
supporting connective tissue

4. Etiology and Pathogenesis
• HPV types and their known associations
• DNA virus 1- benign 2- malignant
• Specifically infect basal epithelia cells and
establishes a productive infection only on
stratified squamous epithelium

5. Clinical
feature
less than 1 cm
Lateral tongue (granular)

6. Clinical
feature
Floor of mouth

7. Clinical feature
• Oral wart , Palate
(cauliflower like)

8. Histopathology

9. Papilloma
Exophytic Finger like
extension of epithelium
supported by well
vascularized connective tissue

10. Oral wart

11. Koilocytic cell
Epithelial nuclei that are pyknotic and
centered surrounded by edematous or
optically clear zone

12. Oral wart
• Positive brown staining
nuclei are seen In upper
level keratinocytes

13. Dysplastic oral warts

14. Dysplastic oral
warts
• A, Note normal epithelium at far
right
• B, stain for proliferation marker
[PCNA] showing positive nuclear
staining (red) in most
keratinocytes

15. Differential
Diagnosis
Verruciform xanthoma
Papillary hyperplasia
Condyloma

16. Verruciform
xanthoma
• Uncommon benine oral mocusal lesion that
occasionally may be found on the skin typically
on the genitalia

17. Etiology and
Pathogenesis
The cause
is Unknown
(NSDHL)

18. Clinical feature: “whites”
granular and papillary (2 mm to 2 cm)

19. Histopathology
• Elongated epithelial ridge
extend into the lamina
propria at a uniform depth
• Note the uniformly
invaginated crypts
alternate with papillary
extension

20. Histopathology
• Note Xanthoma cells (foamy
macrophages) in the lamina
propria or connective tissue
papillae
• Foam? (PAS)
• No evidence of dysplasia
and atypia

21. Differential
Diagnosis
Squamous papilloma
Papillary squamous carcinoma
Condyloma acuminatum

22. References
Diz Dios, P., 2016. Oral medicine and Pathology at a
glance. 2nd ed. West Sussex: WILEY Blackwell.
Eversole, L.R., 2000. Papillary lesions of the oral
cavity: relationship to human
papillomaviruses. Journal of the California Dental
Association, 28(12), pp.922-927.
Regezi, J., 2012. Oral Pathology clinical pathological
correlation. 6th ed. Missoury: Elsevier.