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<p>Exophytic squamous proliferations of the upper aerodigestive tract can exhibit distinctive papillary and verrucous architectural patterns that often complicate diagnostic interpretation. Histologic evaluation is particularly challenging in limited biopsy specimens where the base of the lesion may not be well represented; and diagnostic terminology is confounded by the lack of historical and current consensus nomenclature. The terms “papillary” and “verrucous” are merely descriptive terms that encompass a broad spectrum of benign, premalignant, and malignant entities. Entities discussed in this review include squamous papilloma, papillary hyperplasia, papillary squamous cell carcinoma, oral epithelial dysplasia, verruciform xanthoma, proliferative verrucous leukoplakia (PVL)-related lesions, verrucous carcinoma, and verrucous hyperplasia. Given these challenges, a diagnostic approach to such lesion should include comprehensive clinical correlation and careful morphological assessment. Ultimately, clear consensus guidelines and an adoption of consistent terminology are essential to improve diagnostic reproducibility and patient management.</p>

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Proceedings of the 2025 North American Society of Head and Neck Pathology Companion Meeting, Boston, MA, March 23, 2025: Papillary and Verrucous Squamous Epithelial Proliferation of the Upper Aerodigestive Tract

  • 期刊论文

  • 发表日期：

    2025年10月29日

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  • Juan C. Hernandez-Prera,
  • William H. Westra,
  • Sana O. Tabbara,
  • Bruce M. Wenig

摘要

Exophytic squamous proliferations of the upper aerodigestive tract can exhibit distinctive papillary and verrucous architectural patterns that often complicate diagnostic interpretation. Histologic evaluation is particularly challenging in limited biopsy specimens where the base of the lesion may not be well represented; and diagnostic terminology is confounded by the lack of historical and current consensus nomenclature. The terms “papillary” and “verrucous” are merely descriptive terms that encompass a broad spectrum of benign, premalignant, and malignant entities. Entities discussed in this review include squamous papilloma, papillary hyperplasia, papillary squamous cell carcinoma, oral epithelial dysplasia, verruciform xanthoma, proliferative verrucous leukoplakia (PVL)-related lesions, verrucous carcinoma, and verrucous hyperplasia. Given these challenges, a diagnostic approach to such lesion should include comprehensive clinical correlation and careful morphological assessment. Ultimately, clear consensus guidelines and an adoption of consistent terminology are essential to improve diagnostic reproducibility and patient management.