Pseudoepitheliomatous hyperplasia of the overlying squamous mucosa is commonly present when the lesion involves the palate. Most tattoo reactions involve dermal inflammatory changes. Pseudoepitheliomatous hyperplasia peh, a neglected entity by oral pathologist possesses utmost importance in the field of. Elena zarovnaya and candice black 2005 distinguishing pseudoepitheliomatous hyperplasia from squamous cell carcinoma in mucosal biopsy specimens from the head and neck. Read recurrent primary cutaneous lymphoma with florid pseudoepitheliomatous hyperplasia masquerading as squamous cell carcinoma, histopathology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. It, however, has not been reported as a manifestation in the palpebral form of the disease and needs to be kept in the differential diagnosis of a limbal mass lesion in.
Pseudoepitheliomatous hyperplasia mimicking vulvar cancer. Cytokeratin expression in pseudoepitheliomatous hyperplasia. The 47 lesions of pseudoepitheliomatous hyperplasia in the oral mucosa were diagnosed in association with a great diversity of clinical entities, from infectious stomatites tuberculosis, actinomycosis and candidosis, to chronic inflammatory conditions oral lichen planus and to neoplastic lesions, respectively granular cell tumor and oral squamous carcinoma. Pseudoepitheliomatous hyperplasia is a benign condition, characterized by hyperplasia of the epidermis and adnexal epithelium, closely simulating squamous cell carcinoma. Van marck, department of community health, federal university r. Pseudoepitheliomatous hyperplasia can be seen in a number of settings, as outlined above, and its presence should prompt a search for an underlying infectious process, inflammatory process or tumor as appropriate. Of all the investigative challenges, peh, a reactive. A study of morphometrical differences between normal. Malhotra c, jain ak, thapa b case rep ophthalmol med, 20.
Scanning power view of phaeohyphomycosis shows a deeply extending granulomatous pattern figure 1 which may show areas of necrosis figure 2. The aim of our study was to analyse a series of enktls concomitant with peh. Pseudoepitheliomatous hyperplasia jama dermatology. Apocrine adenoma of the external auditory canal with. Hyperplasia is a response common to a variety of stimuli, often chronic, and occurs in a variety of types, including regular, irregular, papillated, and pseudocarcinomatous pseudoepitheliomatous fig. Pseudoepitheliomatous hyperplasia mimicking invasive. Pseudoepitheliomatous hyperplasia jama dermatology jama. It is an uncommon manifestation of vernal keratoconjunctivitis and has been reported previously in limbal vkc. Pseudoepitheliomatous hyperplasia may be present in a number of conditions characterized by prolonged inflammation andor chronic infection, as well as in association with many cutaneous neoplasms. Squamous cell carcinoma is the second most common cutaneous malignancy. A study of morphometrical differences between normal mucosa. Primary cutaneous lymphomaassociated pseudoepitheliomatous. Pseudoepitheliomatous hyperplasia international journal of. From the department of pathology, dartmouthhitchcock medical.
Erythematous verrucous plaque on the hand mdedge dermatology. Considering the extent to which atypia can occur in pseudoepitheliomatous hyperplasia overlying a granular cell tumor, one can similarly extrapolate what can be found in association with nsm. The epidermis commonly shows pseudoepitheliomatous hyperplasia. Lack of awareness of this association may result in a misdiagnosis of squamous cell carcinoma. Pseudoepitheliomatous hyperplasia an unusual reaction following tattoo. Limbal pseudoepitheliomatous hyperplasia mimicking ocular surface squamous neoplasia in palpebral vernal keratoconjunctivitis. Pseudoepitheliomatous tattoo reaction diagnostic histopathology. Pseudoepitheliomatous hyperplasia arising from purple. It is a diagnostic dilemma which simulates malignancy, especially squamous cell carcinoma scc. Pseudoepitheliomatous hyperplasia peh is a benign reactive inflammatory reaction of the epithelial cells to various conditions.
The patient reported back to us after 1 week with the histopathology report. Pdf pseudoepitheliomatous hyperplasia, also called hecks disease, is an epithelial, inconstant and conjunctive proliferation that develops as a. Pdf histopathological study of oral pseudoepitheliomatous. Pseudoepitheliomatous hyperplasia can be seen in a number of settings, as outlined above, and its presence should prompt a search for an underlying infectious process, inflammatory process or. Diagnostic markers to distinguish between squamous cell. Some forms of epidermal hyperplasia regular, irregular. Pseudoepitheliomatous hyperplasia in chronic inflammation has long been difficult to diagnose. Pseudoepitheliomatous hyperplasia may be present in a number of conditions characterized by prolonged inflammation andor chronic infection, as well as in association with. Havlicek university hospital, department of pathology, dobtany and 2nd institute of pathology, faculty of medicine i, charles university. Epithelial infiltration by inflammatory cells was common, as were microabscesses in the superficial layer. Limbal pseudoepitheliomatous hyperplasia mimicking ocular. However, it has not yet been extensively documented in extranodal natural killert. Pseudoepitheliomatous hyperplasia peh is a benign reactive.
All cases of pmycosis showed pseudoepitheliomatous hyperplasia, with acanthosis and long rete pegs. Pseudoepitheliomatous hyperplasia peh is a benign condition, characterized by hyperplasia of the epidermis and adnexal epithelium, closely simulating squamous cell carcinoma. Frequently a foreign body such as a wood splinter can be seen. Pdf pseudoepitheliomatous hyperplasia peh is a benign condition. Here, we report a case of a ceruminous adenoma apocrine adenoma with refractory chronic inflammation in the external auditory canal. Histopathological study of oral pseudoepitheliomatous. Many articles of peh involving the oral mucosa are available on the internet, but ocular involvement is infrequent. Pseudoepitheliomatous hyperplasia mimicking invasive squamous. Apr 28, 2015 pseudoepitheliomatous hyperplasia peh is a histopathological reaction pattern to various stimuli, which includes trauma, infection, inflammation, neoplasia. Keratinocyte atypia is usually mild and confined to the basal. Histologic evaluation reveals projections of epithelium with jagged bases extending into the dermis. Pseudoepitheliomatous hyperplasia peh, a neglected entity. Pathological changes may arise in epidermis, dermis andor subcutaneous tissue.
Pseudoepitheliomatous hyperplasia of tongue treated by. Peh may be present in a number of conditions characterized by prolonged inflammation andor chronic infection, as well as in association with many cutaneous neoplasms. Pseudoepitheliomatous hyperplasia mimicking vulvar cancer in. Pseudoepitheliomatous hyperplasia, abbreviated peh, is a benign reactive change of squamous mucosa that can mimic squamous cell carcinoma. Pseudoepitheliomatous hyperplasia arising from purple tattoo. For each pattern the histological features are described, the differential diagnosis is discussed and the. Florid pseudoepitheliomatous hyperplasia is a rare and poorly recognized complication of tattooing.
Pseudoepitheliomatous hyperplasia peh is a benign condition. Pseudoepitheliomatous hyperplasia medigoo health tests. Of all the investigative challenges, peh, a reactive epithelial proliferation is seen secondary to lesions with infectious, inflammatory, reactive, and degenerative origin. Pathology outlines pseudoepitheliomatous hyperplasia. A 75yearold retired farmer presented with an erythematous verrucous plaque on the dorsal aspect of the left hand of 4 years duration. A soft reddish protruding lesion was revealed at the posterosuperior portion. Pseudoepitheliomatous hyperplasia is a benign proliferation of the epidermis into irregular squamous strands extending down into the dermis. Problems and pitfalls in oral mucosal pathology diagnostic. Recurrent primary cutaneous lymphoma with florid pseudoepitheliomatous hyperplasia masquerading as squamous cell carcinoma. It is associated with poor denture hygiene, denture overuse, and illfitting dentures. Differentiating cutaneous squamous cell carcinoma and.
Inflammatory papillary hyperplasia is a hyperplasia overgrowth of soft tissue, usually beneath a denture. The aim of our study was to analyse a series of enktls concomitant with peh mimicking squamous cell carcinoma scc. It is seen as tongue like epithelial proliferation invading the connective tissue and should not be mistaken for squamous cell carcinoma scc. Pseudoepitheliomatous hyperplasia is an uncommon finding in primary cutaneous anaplastic large cell lymphoma, and may mimic squamous cell carcinoma as pseudomalignancy. This diagnostic test is rapid, costeffective, and can replace the nonquantitative and subjective diagnostic methods currently used. Feb 20, 2019 a soft reddish protruding lesion was revealed at the posterosuperior portion of the entry to the right external auditory canal by otoscopy. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. T1 pseudoepitheliomatous hyperplasia mimicking vulvar cancer in a patient with aids. Competent pathologists have occasionally been surprised by the spontaneous healing of a lesion which they had diagnosed squamous cell carcinoma microscopically. May 01, 2008 read recurrent primary cutaneous lymphoma with florid pseudoepitheliomatous hyperplasia masquerading as squamous cell carcinoma, histopathology on deepdyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips.
Both atypical cells and proliferating epithelial cells can selectively concentrate the photosensitizing agents, which may trigger photodynamic reactions or secondary effects. Distinguishing pseudoepitheliomatous hyperplasia from. Epidermis hyperplasia an overview sciencedirect topics. A 46yearold man presented with otorrhea, itching, and a foreign body sensation in his right ear. Some forms of epidermal hyperplasia regular, irregular, and pseudocarcinomatous can develop in sequence. Pseudoepitheliomatous hyperplasia peh is a benign condition characterised by hyperplasia of the epidermis and adnexal epithelium closely simulating squamous cell carcinoma scc. At high power branching septate pigmented fungal hyphae can be seen figure 6. With the rising popularity of tattoos, adverse skin reactions to this practise are being increasingly recognized. It is a closely related condition to inflammatory fibrous hyperplasia epulis fissuratum, but the appearance and location differs.
Pseudoepitheliomatous hyperplasia peh, a neglected entity by oral pathologist possesses utmost importance in the field of research. Only buccal mucosa was chosen,to standardize the results in all the 4 study groups,as the fractal dimensions of different zones of oral mucosa vary considerably. Pseudoepitheliomatous hyperplasia peh is a rare tattoo reaction often arising within areas of red or purple ink. Pseudoepitheliomatous hyperplasia can arise either from the epidermis or from adnexal epithelium, and is almost always associated with persistent inflammation of the subjacent dermis due to a chronic wound, ulcer, infection, malignancy, retained foreign. The invention utilizes markers that have been identified through gene expression profile analysis of squamous cell carcinoma and pseudoepitheliomatous hyperplasia. Lipid with surrounding granulomatus reaction molluscum contagiosum. Kelly thornbury1, pratik rastogi 1, robertgates 1 severe burns unit, royal north shore hospital introduction patients with severe burns are subject to significant physiological, immunological and inflammatory insults in both the acute and chronic. Pseudoepitheliomatous hyperplasia peh is a histopathological reaction pattern to various stimuli, which includes trauma, infection, inflammation, neoplasia. Pseudoepitheliomatous hyperplasia arising from purple tattoo pigment. Malhotra c, jain ak, thapa b case rep ophthalmol med. Histopathological study of oral pseudoepitheliomatous hyperplasia. Pseudoepitheliomatous hyperplasia in the setting of cd30. The diagnosis can occasionally be difficult as there are many lesions that are mimics, clinically and on pathologic examination. Superficial biopsies from the lesion 4 years prior to presentation revealed pseudoepitheliomatous hyperplasia suggestive of squamous cell carcinoma, which led to the excision of the lesion along with 2 digits of the left hand.
The inflammatory infiltrate is comprised of histiocytes with multinucleated giant cells, and numerous neutrophils figures 3,4 and 5. A clinical entity mistaken for squamous cell carcinoma suvadip chakrabarti 1, preeti rihal chakrabarti 2, deepak agrawal 1, shreyas somanath 1 1 department of surgical oncology, sri aurobindo medical college and pg institute, indore, madhya pradesh, india 2 department of pathology, sri aurobindo medical. The pattern of changes may allow a diagnosis to be made or it may be nonspecific. The appearance of many skin diseases vary at different stages of their development and may be altered by attempted treatment and secondary changes such as scratching or infection. Prague, czechoslovakia date of submission 2 5 january 199 1 accepted for publication 1 7 april 1991 keywords. Careful attention of a pathologist to correct diagnosis of pseudoepitheliomatous hyperplasia and its underlying causes will help physicians to avoid inappropriate management. The tumors derived of the ceruminous gland in the external auditory canal are rare. Pseudoepitheliomatous hyperplasia peh is defined as a pattern of epidermal reaction. It, however, has not been reported as a manifestation in the palpebral form of the disease and needs to be kept in the differential diagnosis of a limbal mass lesion in vernal. Skin nonmelanocytic tumor dermatopathology patterns. We report herein the first case to our knowledge of peh tattoo reaction treated with carbon dioxide laser. May 24, 20 squamous cell carcinoma is the second most common cutaneous malignancy. Pseudoepitheliomatous hyperplasia at the limbus can mimic an ocular surface squamous neoplasia.
648 580 1095 489 915 684 1135 687 789 348 1211 147 1369 276 486 195 846 1344 1273 468 264 756 778 980 1445 1326 1098 1100 768 1446 486 1213 1125 469 716 1432 1011 971 229 290