Cases of squamous cell carcinoma in situ (i.e., without penetration of the basal membrane) have not been reported in rats. This layer of cells is also called epithelium or epithelial lining because squamous cells are a type of epithelial cell. HPV is now considered to be closely related to EP and esophageal cancer and was suggested as one of the etiological factors [18, 19]. Gastroenterology. Lee K, Lee O, Lee S. Gastrointestinal: diffuse esophageal papillomatosis involving the entire esophagus. Totten RS, Stout AP, Humphreys GH, et al. For many of these compounds, particularly BHA, they act as anticarcinogens in many tissue models, albeit generally at lower doses than those related to the development of carcinomas in the forestomach. The 6 cases were all females aged between 3 and 56years old. WebSquamous metaplasia refers to noncancerous (benign) changes in squamous cells in your epithelium. DL conceived the paper, and was a major contributor in writing the manuscript. Repeat question; here is a more detailed reply. Based on the existing literature, we have a certain knowledge of EPS. Lower magnification of benign squamous epithelium-lined cyst containing keratin World J Gastroenterol. An example of differential X-chromosome inactivation. In addition, varying degrees of esophageal strictures can be found. the unsubscribe link in the e-mail. When a high-risk type HPV is detected, we need to be aware of malignant tumors. Fekete F, Chazouilleres O, Ganthier V, et al. Additionally, high-grade dysplasia can be detected in the EPS tissue [16, 28, 60]. Kato et al. Extensive squamous papillomatosis of the esophagus. It is not known how the HPVs cause the formation of squamous cell papilloma. A rare case of esophageal papilloma due to human papillomavirus with uncommon presentation of dysphagia in a 2-year-old child. Nuwayhid NS, Ballard ET, Cotton R. Esophageal papillomatosis: case report. Hafiz M, Sundaram S, Naqash AR, et al. 2018;16(6):A28. Cohen, in Comprehensive Toxicology, 2010. BMJ Case Rep. 2014. https://doi.org/10.1136/bcr-2013-200195. 2019;52:725. Esophageal epithelial homeostasis is affected by a variety of Usually, papillomas consist of an exophytic mass of uniform, regularly arranged squamous cells that form papillary or filiform structures covering a vascularized connective tissue stalk. Tests might include: Based on the results, your health care provider might recommend next steps. Benign vulvar disorders are a significant issue for patients. Nasal squamous cell carcinomas (Figure 2.7.19) may originate from squamous differentiation of transitional, respiratory or olfactory epithelial cells; epithelial cells of the subepithelial glands; or from malignant transformation of the squamous epithelium of the nasal vestibule. Washington DC: Armed Forces Institute of Pathology; 1957. p. 2532. HealthTap uses cookies to enhance your site experience and for analytics and advertising purposes. Diagn histopathol. EPS current managements are mainly divided into medical, endoscopic, and surgical therapy. Squamous cell carcinomas are composed of solid, often branching cords or masses of cells with various degrees of anaplasia. benign squamous epithelium These islands of cells are surrounded by a basement membrane and are not an indication of malignant change. Despite the effectiveness of these treatments in the short term, endoscopists always felt helpless against EPS repeated recurrence. Google Scholar. Therefore, with variations in the clinical course, close endoscopic surveillance is necessary for early detection of the malignant lesions. Successful treatment of a squamous papilloma of the hypopharynxesophagus by local injections of (S)-1-(3-hydroxy-2-phosphonylmethoxypropyl) cytosine. Brinson RR, Schuman BM, Mills LR, et al. 1990; Ito and Hirose 1989). Can J Gastroenterol. Understanding Your Pathology Report: Esophagus With Or, over time, it could turn into cancer. These findings are benign (non-cancerous). This content does not have an English version. You will likely need followup such as a larger excision to make sure they go it all test and does have false negatives. Neuroepithelial carcinomas often invade the ethmoid bone and brain. Deficiency of PORCN, a regulator of Wnt signaling, is associated with focal dermal hypoplasia. Download : Download high-res image (1MB) Download : Download full-size image Figure 2. PubMed Among the EPS cases, more than a quarter of patients had a prolonged chronic reflux disease and repeated heartburn. 1982;52:28392. Squamous cell papilloma is the most common benign neoplasm of the tracheobronchial tree and is composed of stratified squamous epithelium surrounding a core of fibrovascular tissue. Correspondence to WebA variety of benign squamous epithelial lesions of the mucosa are associated with human papillomaviruses (HPV). Basal cells are columnar in shape with basophilic cytoplasm. Published by Elsevier Ltd. Squamous cell carcinoma is associated with chronic irritation of the bladder for instance, from an infection or from long-term use of a urinary catheter. Abnormal squamous cells are classified as squamous intraepithelial lesion (SIL) and are either low grade or high grade: Low-grade SIL (LSIL) compares to CIN 1 If the lesion is small, entirely removed by the needle biopsy, or unrelated to what was seen on the mammogram, then no further treatment may be needed. include protected health information. The surface may have a prominent keratin layer with retention of nuclei in the outer layers. Both types of lesions are caused by mucosal HPV (mostly HPV-6, HPV-11, and HPV-16). DL focused on the clinical work and researches in the field of gastroenterology, especially gastrointestinal endoscopy for 20years. Although the above treatments raised hopes, some studies considered that endoscopic therapy was not amenable for this condition [50, 53] due to the extensiveness of the lesions. Continuous endoscopic surveillance, with careful and multiple biopsies, is necessary due to the progressive clinical course of most EPS cases and the potential for malignant degeneration. After something that is not typical is detected on a Pap test, your health care provider may recommend more tests. 2001;358:17823. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Dandan Li. Article WebSquamous Metaplasia Metaplastic squamous epithelium is common in patients with severe chronic cystitis such as nonfunctioning bladders or schistosomiasis.87-95 It is Most common in older patients and women. 2017;25:805. Oesophageal papillomata in the child. PubMed Raising an optimal management is extremely difficult for clinicians since no guidelines can be followed. Recently virus-specific DNA was also detected in oral invasive carcinomas. Invasion of the cerebrum or metastases to regional lymph nodes or lung may also occur. information highlighted below and resubmit the form. ACG Case Rep J. Above the dentate line, which separates the anus and rectum, the cells are of a different type and rectal cancer is typically Although part of the effects was temporary, they were confirmed to be helpful in clearing away the lesions [25, 26, 36, 37, 58, 65]. - what does this mean after a colposcopy? Click here for an email preview. Ann Otol Laryngol Rhinol. No significant differences were observed between affected men (24 cases) and women (29 cases). Papillomatosis of the esophagus. Zhonghua Yi Xue Za Zhi Chin Med J (Taipei). Top answers from doctors based on your search: Created for people with ongoing healthcare needs but benefits everyone. Educational text answers on HealthTap are not intended for individual diagnosis, treatment or prescription. Thus, the cause of the malignant transformation is unclear and controversial; however, the malignant potential of EPS cannot be ignored. The diagnosis of EPS with ESCC is extremely difficult and time-consuming due to the extensive and numerous lesions. Esophageal squamous papilloma associated with adenocarcinoma. Dickens P, Srivastava G, Loke SL, et al. Fifty cases including benign cervical tissue, low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), adenocarcinoma in situ of the endocervix, invasive endocervical adenocarcinoma, and endometrial adenocarcinoma were selected. You may opt-out of email communications at any time by clicking on Report on 35 endoscopic cases. Adenomas grow expansively with occasional protrusion into the nasal or paranasal cavities, but may show endophytic growth as well. J Clin Gastroenterol. Many elevated lesions were present in the esophagus (predominantly at the distal esophagus) deeper than the dental arch at 25cm, without abnormal blood vessels on narrow-band imaging and a stainless band by Lugol spraying (Makise et al. Squamous cell bladder cancer is rare in the United States. There is a problem with PubMed Multimedia. 76.2). 2012;44:E1101. The epithelium is a thin tissue that lines glands and organs, including your It's more common in parts of the world where a certain parasitic infection (schistosomiasis) is a common cause of bladder infections. We use cookies to help provide and enhance our service and tailor content and ads. Other symptoms, such as epigastric abdominal discomfort and dyspepsia, were occasionally reported. 2017;27:111922. Syrjnen K, Pyrhnen S, Aukee S, et al. HPV infections and oesophageal cancer. 2017;23:224650. Squamous cell papilloma occurs more often in gavage studies than with other routes of exposure. Springer Nature. Other patients also presented with respiratory symptoms when associated with respiratory papillomatosis, such as noisy breathing, stridor and aphonia [6, 7, 23, 24, 44]. Bertani H, Mirante V, Caruso A, et al. This is an important consideration since exposure to these compounds, both natural and synthetic, is quite substantial in humans. You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox. Successful treatment of diffuse esophageal papillomatosis with balloon-assisted radiofrequency ablation in a patient with Goltz syndrome. Interestingly, 84.62% (11/13) of the lesions were located at the respiratory tract. Bronswijk M, Christiaens P, Moons V. Diffuse esophageal papillomatosis complicated by squamous cell carcinoma. AskMayoExpert. 2004;17:3457. Google Scholar. Chemotherapy and sex: Is sexual activity OK during treatment? Esophageal papillomatosis: an exceedingly rare disease All the above conditions support the hypothesis that mucosal injury and regeneration underlie the etiology of EPS formation. Some of these are DNA reactive and will not be dealt with further here. Benign epithelial tumors. Squamous papillomas of the esophagus. WebThe lining of the vagina has a layer of flat cells called squamous cells. Squamous cell carcinomas exhibit frequent mitoses, cellular or nuclear atypia or invasion into surrounding tissues. Inflammatory endobronchial polyps may show focal squamous metaplasia but are usually composed of voluminous granulation tissuelike stroma and subepithelial, dense, lymphoplasmacytic infiltrates. The vaginal wall underneath the epithelium is made up of connective tissue, muscle, lymph vessels, and nerves. 1992;102:66873. Van Cutsem E, Snoeck R, Van Ranst M, et al. https://doi.org/10.1186/s13023-023-02703-8, DOI: https://doi.org/10.1186/s13023-023-02703-8. Patients with RRP can also associate with EPS, which is HPV induced. A case of esophageal squamous cell carcinoma in situ arising from esophageal squamous papilloma. 43 y.o, not menopausal, no hormones, irregular periods & heavy bleeding w/emb result: fragments of inactive endometrium, scant benign squamous epithelium, no evidence of hyperplasia or malignancy. https://www.cancer.gov/types/cervical. HPV is a non-enveloped double-stranded DNA virus (>8kb), that replicates in the nucleus of infected host cells. Squamous cell papilloma in the oral cavity is characterized by fronds or fingerlike projections originating from a central fibrovascular stalk. Researchers suppose that Goltz syndrome is caused by genetic mutations in the PORCN gene [40, 41] that is associated with a X-linked dominant condition, characteristic of female genetic predominance. Special endoscopy technologies were also used to detect and distinguish EPS lesions, such as narrow band imaging (NBI) with magnifying endoscopy [45, 47, 50], and Lugols solution staining [14, 51] and endoscopic ultrasonography [39, 52, 53]. We use cookies to help provide and enhance our service and tailor content and ads. Squamous Epithelium - an overview | ScienceDirect Topics Google Scholar. Several studies have identified DNA from human papilloma viruses (HPV) in skin tags. Multiple squamous papillomas of the esophagus associated with Goltz syndrome. S Afr Med J. Dis Esophagus. Manage cookies/Do not sell my data we use in the preference centre. Privacy Transitional tumours are found mostly in the lateral meatus of the anterior (proximal) aspect of the nasal cavity. Atypical cells can change back to normal cells if the underlying cause is removed or resolved. Cervical dysplasia: Is it cancer? - Mayo Clinic Lorenzo Melo L, Kruel CDP, Kliemann LM, et al. The neoplastic cells are more pleomorphic than is the case with squamous cell papilloma. ScienceDirect is a registered trademark of Elsevier B.V. ScienceDirect is a registered trademark of Elsevier B.V. Reprinted from Geist, C.E., Zamani, M., 2008. In addition, to improve the esophageal stricture, repeated dilatations, and metal stent placements, were also adopted [14,15,16, 43, 52]. And half of the cases suffered from esophageal cancer [15, 26]. Gencdal G, Degirmencioglu S, Akyldz M. Diffuse esophageal squamous papillomatosis covering the entire esophagus. We can speculate that to some extent, EPS can co-exist with the respiratory system papillomas when HPV positive. Clinicians should be alert when respiratory papillomatosis or Goltz syndrome is disclosed, especially along with dysphasia symptoms. The cells are large cuboidal to columnar, or anaplastic. WebBarretts esophagus is defined by replacement of the normal esophageal squamous mucosa with columnar intestinal metaplasia of the distal esophagus, and carries a 50-100 All authors read and approved the final manuscript. Squamous Papilloma Esophageal squamous papillomas are benign epithelial tumors most often found in the distal esophagus [ 2 ]. squamous Squamous cell carcinoma showing invasive growth into subcutaneous tissue. A portion of the neoplasm is exophytic, with ulcer or erosin on the surface; however most cases are poorly demarcated endophytic masses (Figure 19.18). Cervical cancer screening. Chemotherapy nausea and vomiting: Prevention is best defense. Clinicopathological characteristics of esophageal squamous papillomas in Japanese patientswith comparison of findings from western countries. Korean J Intern Med. A similar regression can also be seen in cervical diseases associated with HPV infections [70]. Until now, all the histopathological diagnoses of an EPS invasive malignancy showed ESCC (Table 3). Clin Endosc. Figure 16. Characteristically, coalescing islands with gradual squamous differentiation and centrally located concentric layers of keratin (keratin pearls) are seen throughout the tumor tissue. Goltz syndrome is a rare multisystem disorder that is characterized by cutaneous, skeletal, dental, ocular, and soft-tissue defects. However, the number of reports on EPS significantly increased to over 40 cases during the past 20years. 24 In children, they are typically pedunculated, multiple, and located inferiorly in the fornix. The reporter speculated that one of the potential mechanisms was the inhibitory effect of the HPMPC diphosphate on the viral DNA polymerization process. Although some cases were first identified by esophagogram, which showed the presence of multiple filling defects, the diagnosis of EPS has to rely on esophagogastroduodenoscopy (EGD). Orphanet Journal of Rare Diseases Although EPS is characteristic under endoscopic examination, its diagnosis should meet the pathological diagnosis. Adenocarcinoma of the nasal cavity with mucus formation growing in the submucosa. So far, there are only 53 cases that can be found in English literature, and that are reported in a form of case reports or combined with mini reviews. Hording M, Hording U, Daugaard S, et al. Papilloma is most common near the limiting ridge between the nonglandular stomach and glandular stomach. However, if they are found on a needle biopsy, it isnt so simple. The appearance of koilocytes, expressing hyperchromatic nuclei and perinuclear halos, supports an HPV squamous epithelium infection. Figure 19.18. However, if they are found on a needle benign Large tumors may cause foreign body sensation, irritation, bleeding, or be cosmetically unacceptable. Mayo Clinic does not endorse companies or products. Copyright 2023 Elsevier B.V. or its licensors or contributors. Wolfsen H, Hemminger L, Geiger X, et al. What does minute fragments of benign endocervical glands, squamous epithelium, inflammation, blood and mucus mean? Papillomas appear in stratified squamous epithelium (skin, oral and pharynx, vagina, cervix, and in areas of squamous metaplasia), urothelium and galactophore ducts. The effects of tumorigenesis with these antioxidants and other nongenotoxic compounds appear to be related to relatively high doses. Kashyap P, Sweetser S, Farrugia G. Esophageal papillomas and skin abnormalities. PubMed Central ACG Case Rep J. Esophageal squamous papillomas are benign epithelial tumors most often found in the distal esophagus . Their etiology is unclear, although links have been proposed to irritation from esophageal reflux, direct trauma, or human papillomavirus (HPV) infection. Recently virus-specific DNA was also detected in oral invasive carcinomas. Tanimu S, Rafiullah, Resnick J, et al. Conjunctival papillomas are categorized into infectious (viral), squamous cell, limbal, and inverted (histological description) based on appearance, location, patient's age, propensity to recur after excision, and histopathology. Some researchers suggested that PCR method should be used to test for HPV DNA due to its high sensitivity [10, 29]; however, others thought that even with more sensitive molecular analysis techniques, HPV DNA is not consistently recovered from the lesions [30, 31]. Politoske EJ. Squamous cell papilloma of the esophagus. Adler et al. 2003;98:S1934. Hematoxylin and eosin staining of the pathological specimens. Google Scholar. Atlas of tumor pathology, section V, Fascicle 20. Ferrari AP, Martins FP. Cite this article. 6 o'clock is the location of the biopsy, the lower edge of the cervix, as viewed by the examiner. EP was classified as an esophageal benign epithelial tumor and its association with cancer is extremely rare [54, 55]. Esophageal endoscopy with A white light, B narrow-band imaging, and C Lugol spraying. It is imperative that you follow your doctor's instructions about follow-up tests. Mitotic figures may be common, particularly in the basal cell layer. Both autosomal and X-linked dominant inheritances have been considered. The appearance of koilocytes, expressing hyperchromatic nuclei and perinuclear halos, supports an HPV squamous epithelium infection. 1982;5:2916. statement and 419080500365)]. 2020 The Authors. 2018;66:E1324. Most published reports of esophageal squamous papilloma have originated from Europe Gastroesophageal reflux is the most popular chemical factor that is associated with an underlying esophageal inflammatory process. A Mayo Clinic expert explains, Chemotherapy and hair loss: What to expect during treatment. They are observed most often in the anterior nasal cavity, arising from the epithelium of the lateral walls, septum, naso- and maxilloturbinates, and in the ethmoturbinates. Squamous Neoplasia in the Esophagus From: Specialty Imaging: Thoracic Neoplasms, 2016, T. Utheim, D.A. Influence of surgically induced gastric and gastroduodenal content reflux on esophageal carcinogenesisexperimental model in Wistar female rats. This word Read More Created for people with ongoing healthcare needs but benefits everyone. Siu W, Murray GI, McKinlay A, et al. Z Gastroenterol. By continuing you agree to the use of cookies. It seems similar to EP but has its own characteristics. The mechanism by which these chemicals cause forestomach carcinogenesis is unclear, but may be related to alterations in glutathione metabolism. Nobbenhuis MA, Helmerhorst TJ, van den Brule AJ, et al. Elsevier; 2023. https://www.clinicalkey.com. Because of the papillary nature of the lesion, clusters of epithelial cells may appear in the stalk as the result of tangential sectioning. Infiltrating squamous cell clusters and strands with malignant nuclei and eosinophilic cytoplasm. Since HPV infection was suggested as one of the EPS causes, etiological treatments were therefore, administered. Once the diagnosis is established, an HPV test should be performed to estimate the risk level and explore potential therapeutic strategies. Epithelial Cells: What Are They? - WebMD Some researchers recommended that EP should be removed because of the potential malignancy [69]. Frequency and morphology of rosette structures are highly variable. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. EPS may result from chronic mucosal irritation which is induced by chemical and mechanical mucosal injuries. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Am J Gastroenterol. Eur J Hum Genet. The tumours may contain undifferentiated epithelial cells. Review/update the The causes of skin tags are not well understood. Most studies thought of EPS as multiple and extensive esophageal squamous papillomas. Donnellan F, Walker B, Enns R. Esophageal papillomatosis complicated by squamous cell carcinoma. Nuclei are enlarged, bizarre, and variable in size, with prominent nucleoli; there are also numerous mitotic figures. 2019;6:14. Recently virus-specific DNA was also detected in oral invasive Takeki Uehara, Kathleen A. Szabo, in Boorman's Pathology of the Rat (Second Edition), 2018. 2000;95:15923. McDonald N, Amateau S. Treatment of diffuse esophageal squamous papillomatosis with cryotherapy. Am J Gastroenterol. Joel R. Leininger, Melissa Schutten, in Boorman's Pathology of the Rat (Second Edition), 2018. CAS Squamous cell papilloma of the esophagus: report of a case after peptic esophagitis and repeated bougienage with review of the literature. The squamous epithelium is composed of epithelial cells that are distinctively flat and scale-like. Entrapped glands within the papillomas stalk should not be mistaken for invasion. Papilloma has a fibrovascular core that may contain enlarged vessels and lymphocytic infiltrates. Of interest with respect to human carcinogenesis for these compounds is the relationship to dose, leaving aside the issue that there is no analogous structure to the rodent forestomach in humans. Article Am J Gastroenterol. Int J Pediatr Otorhinolaryngol. WebPresence of human papillomavirus DNA in benign and precancerous oral leukoplakias and squamous cell carcinomas A variety of benign squamous epithelial lesions of the mucosa are associated with human papillomaviruses (HPV). Article To further understand this exceedingly rare disease, we had a comprehensive review of the epidemiology, etiology, clinical manifestations, pathogenesis, treatment, and clinical course of EPS. Syrjnen KJ. It is called squamous mucosa when the top layer is made up of squamous cells. Squamous cell papilloma is a rare, small, wart-like lesion, and biopsy reveals a papillary hyperplasia of the squamous layer without dysplasia. HPV can be grouped as high or low risk according to their contribution to malignant changes. Dysphagia is the first observed symptom and constitutes the most typical manifestation of this condition. In addition to chronic mucosal irritation and HPV infection, genetic factors are also involved in EPS pathogenesis. A cellular damage-repair response, induced by prolonged chemical and mechanical mucosal irritations could contribute to an hyperregeneration process, associated with EPS development. 1999;44:45761. This endophytic type has neither invasive nor compressive growth into surrounding tissues. why inactive? WebSquamous metaplasia is also white. It is well known that the vast majority of recurrent respiratory papillomatosis (RRP) lesions are caused by the above 2 types [32]. Squamous papilloma of the esophagus associated with the human papillomavirus. Saravanan R, Youshya S, Campbell F, et al. 2004;17:18790. Squamous epithelium - Biology Articles, Tutorials WebIf a tumor is benign, or non-cancerous, and is found in the epithelium, it is either an adenoma or papilloma. Understanding Your Pathology Report: Barretts Esophagus (With Google Scholar. Einstein (So Paulo). Orphanet J Rare Dis 18, 99 (2023). Other EPS cases can also be found to be associated with oropharyngeal cancer and gastric adenocarcinoma [27, 62, 63], for which there are no suitable explanations. 1998;316:2858. Spontaneous squamous cell papilloma occurs in aged rats and is not associated with papilloma virus, Fibropapilloma, a papilloma with an increased amount of fibrous tissue (apparently fibroma) described in cattle, horse and turtle, has not been observed in rats. EPS is a benign lesion with a highly malignant potential. However, based on the literature, there is no evidence that EPS is associated with a geographic origin. Most of the esophagus is lined by squamous mucosa. Esophageal papillomatosis in the adult. Hording et al. The criteria of EP were first demonstrated by Stout and Lattes in the 1950s [1, 2]. Bladder cancer Transitional epithelial cell adenomas are found mostly in the lateral meatus of the anterior (proximal) aspect of the nasal cavity. WebSpecifically, conjunctival papillomas are benign squamous epithelial tumors with minimal propensity toward malignancy. Unfortunately, the treatment effects were poor and resulted in a repeated recurrence [7]. Lio WJ, Huang CK, Chen GH. 2006;101:24236. Understanding Your Pathology Report: Benign Breast It can be seen in nearly half of the HPV positive cases with EPS [15, By continuing you agree to the use of cookies. 2) [47]. True rosettes or pseudorosettes may be present. Esophageal papillomatosis from human papilloma virus proven by polymerase chain reaction. 2002;55:7218. In the reports of 53 EPS cases, 29 cases underwent HPV detection, 37.9% (11/29) detected HPV in these patients (Table 1). Although the etiology of EPS is as unclear as EP, it is now thought that several factors are related to EPS incidence, such as chronic mucosal irritation, human papilloma virus (HPV) and genetic factors. Squamous papilloma of the esophagus. 2006;39:2330. 76.1). 32463253. Endoscopy. A spectrum of lesions may occur in positive carcinogenicity studies, especially when multiple proliferative lesions of the oral mucosa are present. Squamous cell papilloma occurs most frequently on the dorsum of the tongue. In: Principles and Practices of Ophthalmology, third ed. Atypical cells don't necessarily mean you have cancer. A large number of non-DNA-reactive chemicals cause tumors in the forestomach by increasing proliferation. A case of esophageal squamous papillomatosis. And up to now no guidelines can be followed. Mayo Clinic; 2022. The prevalence of HPV in these different lesions varies, which makes a causative link difficult to establish. Benign Squamous Cells Cancer Survivors Network Squamous cell papilloma is a benign epithelial neoplasm forming well-circumscribed exophytic papilliform and cauliflower-shaped mass. Reed PA, Limauro DL, Brodmerkel GJ Jr, et al. No. Squamous Metaplasia: Causes, Symptoms and Treatments Selvan B, Ramachandran A, Korula A, et al. William Culviner answered ENT and Head and Neck Surgery 32 years experience Hyperkeratosis: The tongue is covered with squamous epithelium or mucosa, therefore, they said it was benign or normal squamous mucosa with hyperkeratosis.
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