Verruciform xanthoma associated with lichen planus

Verruciform xanthoma (VX) is a rare benign lesion of unknown etiology, with a rough or papillary aspect, painless, sessile, well-defined, most lesions do not exceed 2 cm in their largest diameter, the degree of keratinization of the surface influences color, varying white to red, affecting mainly t...

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Main Authors: Cristianne Kalinne Santos Medeiros, Glória Maria de França, Weslay Rodrigues da Silva, Joaquim Felipe Júnior, Hébel Cavalcanti Galvão, Patrícia Teixeira de Oliveira
Format: Article
Language:English
Published: University of São Paulo 2022-06-01
Series:Autopsy and Case Reports
Subjects:
Online Access:https://www.revistas.usp.br/autopsy/article/view/199297
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author Cristianne Kalinne Santos Medeiros
Glória Maria de França
Weslay Rodrigues da Silva
Joaquim Felipe Júnior
Hébel Cavalcanti Galvão
Patrícia Teixeira de Oliveira
author_facet Cristianne Kalinne Santos Medeiros
Glória Maria de França
Weslay Rodrigues da Silva
Joaquim Felipe Júnior
Hébel Cavalcanti Galvão
Patrícia Teixeira de Oliveira
author_sort Cristianne Kalinne Santos Medeiros
collection DOAJ
description Verruciform xanthoma (VX) is a rare benign lesion of unknown etiology, with a rough or papillary aspect, painless, sessile, well-defined, most lesions do not exceed 2 cm in their largest diameter, the degree of keratinization of the surface influences color, varying white to red, affecting mainly the gingiva and alveolar mucosa, and can also be seen in skin and genital. Herein, we present a report a clinical case of oral verruciform xanthoma in the buccal mucosa associated with the lichen planus lesion, as well as the morphological and immunohistochemical characteristics of the lesion. The clinical diagnostic hypothesis of oral lichen planus of the white reticular lesions on the buccal mucosa and on the tongue was confirmed by histopathology before a subepithelial connective tissue exhibiting intense inflammatory infiltrate in a predominantly lymphocytic band. In contrast, the hypothesis of the verrucous lesion in the left buccal mucosa was leukoplakia, with histopathological evidence showing exophytic and digitiform proliferations with parakeratin plugs between the papillary projections. Subepithelial connective tissue was characterized by macrophages with foamy cytoplasm (xanthoma cells). An immunohistochemical examination was performed, showing positivity for CD68, a macrophage marker, in addition to testing by Schiff's periodic acid (PAS) with diastasis, which was detected the presence of lipids inside these macrophages. The patient is free of recurrences of verruciform xanthoma and is being monitored due to the presence of lesions of oral lichen planus.
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spelling doaj.art-e9e779998f45458a89e385c46bda4ca22022-12-22T02:33:29ZengUniversity of São PauloAutopsy and Case Reports2236-19602022-06-0112Verruciform xanthoma associated with lichen planusCristianne Kalinne Santos Medeiros0Glória Maria de França1Weslay Rodrigues da Silva2 Joaquim Felipe Júnior3Hébel Cavalcanti Galvão4Patrícia Teixeira de Oliveira5Universidade Federal do Rio Grande do Norte, Stomatology and Oral Pathology, Natal, RN, Brasil Universidade Federal do Rio Grande do Norte, Stomatology and Oral Pathology, Natal, RN, BrasilUniversidade Federal do Rio Grande do Norte, Stomatology and Oral Pathology, Natal, RN, BrasilUniversidade Federal do Rio Grande do Norte, Stomatology and Oral Pathology, Natal, RN, BrasilUniversidade Federal do Rio Grande do Norte, Stomatology and Oral Pathology, Natal, RN, BrasilUniversidade Federal do Rio Grande do Norte, Stomatology and Oral Pathology, Natal, RN, Brasil Verruciform xanthoma (VX) is a rare benign lesion of unknown etiology, with a rough or papillary aspect, painless, sessile, well-defined, most lesions do not exceed 2 cm in their largest diameter, the degree of keratinization of the surface influences color, varying white to red, affecting mainly the gingiva and alveolar mucosa, and can also be seen in skin and genital. Herein, we present a report a clinical case of oral verruciform xanthoma in the buccal mucosa associated with the lichen planus lesion, as well as the morphological and immunohistochemical characteristics of the lesion. The clinical diagnostic hypothesis of oral lichen planus of the white reticular lesions on the buccal mucosa and on the tongue was confirmed by histopathology before a subepithelial connective tissue exhibiting intense inflammatory infiltrate in a predominantly lymphocytic band. In contrast, the hypothesis of the verrucous lesion in the left buccal mucosa was leukoplakia, with histopathological evidence showing exophytic and digitiform proliferations with parakeratin plugs between the papillary projections. Subepithelial connective tissue was characterized by macrophages with foamy cytoplasm (xanthoma cells). An immunohistochemical examination was performed, showing positivity for CD68, a macrophage marker, in addition to testing by Schiff's periodic acid (PAS) with diastasis, which was detected the presence of lipids inside these macrophages. The patient is free of recurrences of verruciform xanthoma and is being monitored due to the presence of lesions of oral lichen planus. https://www.revistas.usp.br/autopsy/article/view/199297Foam cellsMouth MucosaPathology
spellingShingle Cristianne Kalinne Santos Medeiros
Glória Maria de França
Weslay Rodrigues da Silva
Joaquim Felipe Júnior
Hébel Cavalcanti Galvão
Patrícia Teixeira de Oliveira
Verruciform xanthoma associated with lichen planus
Autopsy and Case Reports
Foam cells
Mouth Mucosa
Pathology
title Verruciform xanthoma associated with lichen planus
title_full Verruciform xanthoma associated with lichen planus
title_fullStr Verruciform xanthoma associated with lichen planus
title_full_unstemmed Verruciform xanthoma associated with lichen planus
title_short Verruciform xanthoma associated with lichen planus
title_sort verruciform xanthoma associated with lichen planus
topic Foam cells
Mouth Mucosa
Pathology
url https://www.revistas.usp.br/autopsy/article/view/199297
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