PMC5937561_01
Lingual lesion with slightly raised margins and a granular surface closely associated with a white plaque and striae (a). Whitish striae located on the right (b) and left (c) buccal oral mucosa of the patient.
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The lesion was soft in consistency on palpation and closely related to an area of combined white plaque and striae (Figure 1). Similar white striae in a reticular pattern were also observed in the right and left buccal mucosa consistent with the clinical diagnosis of OLP (Figures 1 and 1).
Photomicrograph of the VX that demonstrates hyperparakeratosis with keratin plugs, elongated, thickened epithelial rete ridges, and subepithelial connective tissue filled by foamy cells (arrows). The oral mucosa adjacent to the lesion shows a band-like (asterisks) dense inflammatory infiltrate (hematoxylin and eosin stain, x150). A higher magnification (inset, x400) showing epithelial parakeratosis, acanthosis, basal cell hydropic degeneration, and subepithelial predominant lymphocytic infiltrates.
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Microscopic examination showed hyperparakeratosis and acanthosis with projections of the surface epithelium in a verrucous pattern, intense orange parakeratin plugs, and elongated thickened rete ridges (Figures 2 and 3(a)). Accumulation of foamy cells in the subepithelial connective tissue confined in the lamina propria papillae was noted with sparse inflammatory infiltrates (Figures 2 and 3(b)). Specifically, the epithelial hyperplastic pattern in a transitional manner changed into a relatively thinner squamous epithelium that exhibited parakeratosis, basal cell hydropic degeneration, and a band-like subepithelial dense chronic inflammatory infiltrate mainly by lymphocytes (Figure 2, inset).
Low-power histologic aspect of the lesion (a) demonstrating exophytic growth in a verrucous/warty pattern with epithelial projections, hyperparakeratosis, orange keratin plugs, and elongated, thickened epithelial rete ridges (hematoxylin and eosin stain x150). Higher magnification (b) shows aggregates of foamy cells (arrows) in the connective tissue between the rete ridges (hematoxylin and eosin stain x400), which express (c) strong immunoreactivity for CD68 (immunohistochemical stain, x400).
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Microscopic examination showed hyperparakeratosis and acanthosis with projections of the surface epithelium in a verrucous pattern, intense orange parakeratin plugs, and elongated thickened rete ridges (Figures 2 and 3(a)). Accumulation of foamy cells in the subepithelial connective tissue confined in the lamina propria papillae was noted with sparse inflammatory infiltrates (Figures 2 and 3(b)). Tucson, AZ). The foamy cells exhibited strong immunostaining for CD68 (Figure 3(c)).