Papillary hyperplasia

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E.W. Odell

Papillary hyperplasia is an asymptomatic nodular or papillary mucosal lesion typically seen in the palate of patients who wear dentures. Most patients wear ill-fitting dentures, wear dentures continuously {2645} or have poor denture hygiene. Lesions also arise in non-denture wearers, in xerostomia or individuals with a high arched palate. Florid and extensive presentations occur in immunosuppres-sion {937} and HIV infection {2150}. There is sessile nodular papillomatous hyperplasia of epithelium and supporting underlying fibrous tissue. There is usually parakeratinisation or less frequently orthokeratinisation. Rete processes are

Median rhomboid glossitis typically forms a patch of papillary atrophy near the midline of the dorsum of the tongue at the junction of the anterior two thirds and posterior third in the region of the embryological foramen caecum. It is no longer thought to be a developmental defect but the result of chronic candidal infection {719,2825}.

The epithelium lacks papillae, and shows usually rounded or sharply defined at the base of the lesion but there may be pseu-doepitheliomatous hyperplasia with keratin pearls and a poorly defined deep margin. Differential diagnosis includes diffuse HPV-induced papillomatosis, periorificial plasmacytosis {937} and verruciform xanthoma. Other multinodular lesions such as focal epithelial hyperpla-sia, acanthosis nigricans and Cowden syndrome appear similar histologically but have distinctive clinical presentations.

psoriasiform hyperplasia and sometimes areas of pseudoepitheliomatous hyper-plasia. A mild degree of atypia may be present. Fungal hyphae are present in the superficial epithelium but are usually sparse and revealed only in multiple sections. Scarring and nodularity persist after antifungal treatment. Differential diagnosis is aided by knowledge of the specific site and includes reactive

Fig. 4.30 Papillary hyperplasia. Low power view showing the overall architecture with nodular fibroepithelial hyperplasia and apparently detached islands of epithelium in the upper corium. Inflammation is slight in this example but depends on candidal infection and whether a denture overlies the lesion. It may be a very prominent feature.

Fig. 4.30 Papillary hyperplasia. Low power view showing the overall architecture with nodular fibroepithelial hyperplasia and apparently detached islands of epithelium in the upper corium. Inflammation is slight in this example but depends on candidal infection and whether a denture overlies the lesion. It may be a very prominent feature.

E.W. Odell fibroepithelial hyperplasia, granular cell tumour and other nodular lesions of the tongue. Occasionally the lesion can be difficult to differentiate from squamous cell carcinoma {931, 1932}, particularly when hyperplasia is extensive and epithelial processes reach or penetrate the underlying muscle.

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Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

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