Histopathology

The histological features are more distinctive than squamous papilloma or condyloma. Each lesion is a slightly raised or rounded sessile swelling formed by a sharply demarcated zone of epithelial acanthosis, similar to condyloma acuminatum but with a less prominent papillomatous structure. The bulk of lesion is formed by exophytic acanthosis, without formation of well-defined projections of epithelium and the lesion contains minimal connective tissue papillae. Koilocytes similar to those of squamous papilloma are usually present and, in addition, there are usually characteristic "mitosoid bodies", which are nuclei with coarse clumped heterochromatin resembling a mitotic figure. Mitosoid bodies are characteristic but not specific for focal epithelial hyperplasia. The base of the lesion is flat and level with the adjacent epithelium without rete process enlargement {332,2076}. HPV may be detected on immunocytochemistry or by in-situ hybridisation but this is not necessary for diagnosis if the clinical presentation is typical {2076}.

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