Table of Contents
Definition / general | Essential features | Epidemiology | Sites | Etiology | Clinical features | Diagnosis | Treatment | Gross description | Microscopic (histologic) description | Cytology description | Differential diagnosis | Board review style question #1 | Board review style question #1Cite this page: Li Z. Squamous papilloma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixsquamouspapilloma.html. Accessed April 20th, 2024.
Definition / general
- Benign polypoid lesion composed of a single papillary frond with a central fibrovascular core and mature squamous epithelium
Essential features
- Composed of a single papillary frond with a central fibrovascular core and mature squamous epithelium without complex arborizing architecture, acanthosis or cellular atypia (koilocytes)
Epidemiology
- Usually women of reproductive age
Sites
- Lower genital tract (vagina, vulva, less commonly in cervix)
Etiology
- Unrelated to HPV infection
- Predisposing factors unknown
Clinical features
- Usually asymptomatic but may be associated with burning or dyspareunia
Diagnosis
- Composed of a single papillary frond with a central fibrovascular core and mature squamous epithelium
- Lacks the complex arborizing architecture, acanthosis and cellular atypia of koilocytes
Treatment
- Excision is curative
Gross description
- May be single or multiple polypoid lesions, usually 5 mm or less
Microscopic (histologic) description
- Composed of a single papillary frond with a central fibrovascular core and mature hyperplastic squamous epithelium
- Lacks koilocytic features: complex arborizing architecture, acanthosis, cellular atypia, mitosis
Cytology description
- Usually negative for abnormal / atypical cells
Differential diagnosis
- Cervical / endocervical polyp:
- Covered with single layer of squamous epithelium or glandular epithelium
- Condyloma:
- Complex arborizing architecture, acanthosis, koilocytosis
- Ki67 and HPV IHC may be helpful (Am J Surg Pathol 2000;24:1393, Am J Surg Pathol 2013;37:300)
- Papillary immature metaplasia
- Verrucous carcinoma:
- Marked cellular atypia with mitosis, pushing border growth pattern
- Well differentiated squamous cell carcinoma:
- Marked cellular atypia with mitosis, infiltrating growth pattern with stromal reaction
Board review style question #1
- Which of the following is true about squamous papilloma:
- It typically shows a complex arborizing architecture and acanthosis
- It is a benign lesion with proliferation of squamous epithelium
- It is a high risk HPV related lesion
- Koilocytes are present
Board review style question #1
B. It is a benign lesion with proliferation of squamous epithelium
