Squamous Papilloma

Elizabeth A. Montgomery, MD

Key Facts

Terminology

Benign tumor composed of hyperplastic squamous epithelium, overlying finger-like cores of lamina propria

Clinical Issues

Recurrences rare
Synchronous or metachronous carcinomas of upper aerodigestive tract reported
- May be coincidental, as this has not held up in epidemiologic studies
- Squamous papillomas are probably NOT markers for upper aerodigestive malignancy
Papillomas do not themselves undergo malignant transformation

Microscopic Pathology

Bland polypoid squamous mucosa
Fibrovascular cores

Hematoxylin & eosin low magnification shows a squamous papilloma with fronds and vascular cores after endoscopic removal. Note the edematous lamina propria

and the band of muscularis mucosae

This is a typical appearance of a squamous papilloma on biopsies, as opposed to the appearance of the endoscopic mucosal resection from the previous image. Neither lamina propria nor muscularis mucosae are seen.

TERMINOLOGY

Definitions

Benign tumor composed of hyperplastic squamous epithelium overlying finger-like cores of lamina propria
- Association with human papilloma virus (HPV) is debatable
  - In most studies, only rare lesions have HPV detected by in situ hybridization or PCR
  - High prevalence in early studies may reflect faulty PCR technique
  - In more recent studies, < 10% of lesions are related to HPV
- Patients with laryngeal papillomatosis can also have esophageal papillomatosis
  - In this case, lesions are associated with HPV