2. Lesions of H&N squamous epithelium

Question 1

Which are the 3 most common leasions affecting HN squamous epithelium?

Answer 1

• Oral squamous cell papilloma
• Squamous intraepithelial lesions
• Invasive squamous cells carcinoma

Question 2

Oral squamous cells papilloma: histology, clinical presentation, physiopathology, diagnosis, treatment

Answer 2

• Exophytic papillary lesion, composed of fibrovascular projections covered by a benign proliferation of suamous epithelium.
• Sensation of foreign body. Thick, white papillae visible on the oral mucosa
• Main etiological factor is HPV 6 and 11. Colonize the basal epithelium replicates spreading to more superficial layers producing the papilla
• Bioptic specimen, infection confirmed by IHC/ISH with AB against p16, doublechecked by PCR
• Surgical removal

Question 3

Squamous intraepithelial lesions: definition and etiological factors, diagnostic approach

Answer 3

• Squamous lesions with atypical features and a potential to evolve towards cancer.
• Tobacco, alcohol, chewing tobacco and betel
• Excision to assess the histology and exclude the DD with cancer
• Grading system: high or low grade based on architectural and cytological criteria

Question 4

Exophytic

Answer 4

Tending to grow outward beyond the surface epithelium from which it originates

Question 5

Clinical manifestation of squamous intraepithelial lesions

Answer 5

• Leukoplakia
• Erythroplakia
• Chronic laryngitis

Question 6

Leukoplakia

Answer 6

• White patch
• Squamous epithelium with nuclear atypia and pleomorphic
• Highly proliferative lesions

Question 7

Erythroplakia

Answer 7

• Area of the mucosa with irregular borders, appearing reddish
• Histology of leukoplakia + proliferating vessels