Presentation on theme: "Benign Tumours of Epithelial Origin"— Presentation transcript:
1 Benign Tumours of Epithelial Origin PapillomaC/fAge 2-5th decade of lifeMore in males, can affect an sexMost common site is tongue, followed by buccal mucosa, lip, gingivaClinically- cauliflower like growth, having finger like projections, usually pedunculated, may be sessile, pinkish in colour; if keratinized, then colour is greyish whiteUsually painless unless secondarily infectedResembles verucca vulgaris occuring on fingers, caused by HPV
2 Papilloma Contd.. Histological Features Each finger like process has a connective tissue core covered by epithelium which is hyperplasticIf keratinized, then para or ortho keratinization is found on the surface of projectionsInflammatory cells may be present if ulcerated surface
3 Keratoacanthoma or self healing carcimoma It is a benign epithelial neoplasm which histologically resembles carcinomaEtiology unknown, suggested to be viral, genetic, chemical carcinogens etc.
4 Keratoacanthoma CLINICAL FEATURES: Usually occurs on external surface like lip, nose, cheek, Zygoma etc.Age 5th to 7th decade of lifeMore common in males1.5 to 2 cm in diameter
5 Keratoacanthoma: Clinical course Initially appears as nodule, which ulcerates and becomes crater like ulcerated nodule, keratin is present within the ulcerIt grows to its full size in 4-8 weeks, remains static, then in following 6-8 weeks, it expels the central keratin core and heals, hence called as self healing carcinoma, recurrence is rare.
6 Keratoacanthoma Histological Features: Hyperplastic squamous epithelium growing into underlying connective tissueSurface covered by thick layer of ortho & para Keratin with central pluggingOccasional dysplastic features are seen in the epithelial cellsAt the leading margin of tumour, islands of epithelium appear to be invading connective tissue and it is almost impossible to differentiate it from Squamous cell CarcinomaPerineural invasion has also been reported, but does not have an adverse effect on biological nature of tumour
7 Keratoacanthoma H/F Contd.. Connective tissue is infiltrated with chronic inflammatory cellsAt the margin of the lesion, the normal adjacent epithelium is elevated towards the central portion of crater, then an abrupt change of normal epithelium occurs into Hyperplastic Acanthotic epitheliumHence, Inclusion of the adjacent border of specimen is must in the biopsy to reach a conclusion.
8 Benign Epithelial Tumors Contd.. Pigmented Cellular NevusNevus is a developmental tumor like malformation, composed of nevus cells.Melanin pigment is present in tumor cells
9 Pigmented Cellular Nevus Two typesCongenitalSmall cms in sizeGarment - more than 10 cms in sizeAcquiredIntradermalJunctionalCompoundSpindle cell typeBlue Nevus
10 Pigmented Cellular Nevus Congenital NevusThese are macules, Pale or coloured and are raised or elevatedThese subsequently show hair growth on their surfaceAre present at birthAcquired NevusPresent 2-3 yrs after birthNumber increases till 3rd decade of life, then decrease in numberUsually small in sizePigmentedWith or without hair growth on surfaceThis type is mostly seen in oral cavity, common sites are palate & gingiva
11 Histopathology:Main cell is nevus cell. These are large ovoid cells with vesiculated nuclei, and pale cytoplasmThey are derived from neural crest cells