Benign epithelial oral lesions – association with human papillomavirus

Abstract

Background The presence of human papilloma virus in benign oral lesions has been studied by different techniques obtaining extremely variable results. The objective of this study was to determine the presence of human papillomavirus in 83 cases of benign hyperplastic epithelial oral lesions. Material and Methods Eighty-three oral lesions with clinical or histopathological features suggestive of HPV infection were retrieved from the files of four oral pathology services. Demographic data were obtained from patient´s medical charts. All cases had available clinical image, H&E preparations and paraffin blocks with enough tissue for HPV detection by in situ hybridization, and immunohistochemical reactions for Ki67. Results Episomal positivity for wide spectrum HPV was observed in 24% of the cases; most of them (70%) HPV 6/11 positive. HPV 16/18 was not detected. Condyloma acuminatum was the most common lesion associated with HPV (75%), followed by verruca vulgaris (15%), squamous papilloma and multifocal epithelial hyperplasia, 5% each. Koilocytes were identified in all the HPV positive cases. Ki67 showed an abnormal proliferation pattern in 90% of the HPV positive cases; most of them (70%) showing groups of proliferating cells in focal superficial regions, and in 20% positivity was seen almost in the whole thickness of the epithelium. HPV negative cases showed Ki67 positive cells restricted to the basal layer. Conclusions Regarding oral lesions associated with HPV, condyloma is the most common lesion expressing low-risk subtypes. The etiology of squamous papilloma remains controversial as HPV was found in 1.9% of the cases. The identification of koilocytes and the pattern of expression of Ki67 reflect HPV infection and are helpful for classification. Papillary oral lesions not associated to HPV deserve further studies to better clarify its etiology. Key words: Human papillomavirus, condyloma, papilloma.

Oral condyloma acuminatum with changes in excretory duct of minor salivary gland: An unusual case report and review of literature

“…Verruca vulgaris is induced commonly by HPV 2, 4, 40 and 57, while CA and squamous papilloma are associated commonly with HPV 6 and 11, and HPV 13 and 32 commonly cause focal epithelial hyperplasia. [ 6 8 9 ] CA is usually diagnosed in teenagers and young adults, but all ages are susceptible. [ 4 ] The lesions are likely to be multiple and frequently occur on the tongue, lips, palate buccal mucosa and floor of the mouth or at the site of contact/due to trauma, with equal gender predilection.…”

“…This is easily differentiated from squamous papilloma, verruca vulgaris and CA by lack of pronounced surface projections and presence of mitosoid cells. [ 4 6 ]…”

“…[ 5 11 ] Koilocytes, a hallmark of CA and HPV infection, are modified keratinocytes consisting of nonuniform perinuclear halos and accompanied by nuclear enlargement and hyperchromasia. [ 5 6 7 ] The papillomatosis and nonuniform perinuclear halos were significantly correlated with HPV and in equivocal cases of oral condyloma. [ 5 ] In the present case, microscopic examination shows papillary parakeratotic stratified squamous epithelium with cryptic invagination in few areas along acanthosis and basal cell hyperplasia.…”

“…[ 3 ] CA is the most commonly associated with low-risk type of HPV including HPV 6 and 11. [ 6 ] Oral CA may involve the excretory ducts of the minor salivary gland. [ 7 ] Here, we present a case of oral CA on lower lip with changes in the excretory duct of the minor salivary gland which is relatively unusual and not much described.…”

HPV Lesions and Other Issues in the Oral Cavity Treatment and Removal without Pain

“…Various lesions in the oral cavity have been related to the Human Papilloma Virus (HPV) infection: verruca vulgaris (VV), squamous cell papilloma (SP), condyloma acuminatum (CA), and multifocal epithelial hyperplasia (MFEH) [ 1 ]. All of them are a benign hyperplastic exophytic proliferation of the oral epithelium [ 2 ], caused by different HPV genotypes. Subtypes 6 and 11, with a low-oncogenic risk, are the most commonly found and cause CA in both the oral cavity [ 2 ] and in the anogenital region [ 3 ].…”