• 대한소아치과학회지
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• 제29권4호
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• pp.581-585
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• 2002

Focal epithelial hyperplasia(FEH)는 구강편평상피의 국소적인 증식으로 사람유두종바이러스(Human papilloma virus)에 의해 유발되는 것으로 알려져 있다. 보통 어린 나이에 호발하며 종종 젊은 성인에서 발생하기도 한다. 협,순측 및 설측 점막에 호발하지만 치은이나 혀의 병소(lesions of tongue)도 보고된 바 있다. 이 병소는 전형적으로 다발성인 부드럽고 촉진 시 압통이 없는 편평한 구진이나 반의 형태를 갖는다. 종종 유두상의 표면을 보이기도 한다. 각각의 병소는 비교적 작고 분리되어 있으며 잘 경계지어진다. FEH의 조직학적 특징은 구강 상피의 유극세포증(acanthosis)이다. 그 밖에 바이러스에 의한 세포병리학적 변화를 나타내는 구멍세포(koilocyte)나 유사분열상 세포(mitosoid cell)가 관찰되기도 한다. 본 증례의 5세 여자환아는 치은의 돌기성 병소를 주소로 연세대학교 치과대학병원 소아치과에 내원하였다. 임상구강검사 결과 무경형의 유두상 구진(sessile papillary papules)이 상악 좌우측 제 2 유구치 협측 치은에서 관찰되었다. 촉진 시 동통은 없었다. 조직학적 검사를 위해 조직생검을 시행하였으며, 유극세포증이 관찰되었다. 이에 FEH로 진단되어 보고하는 바이다. FEH는 몇 달이나 몇 년 이내에 자발적으로 소멸하므로 일반적으로 치료는 불필요하다. 다만 진단적인 이유나 심미적인 이유로 보존적인 절제술을 시행하기도 한다. 이러한 치료 후 재발의 위험은 최소한이며, 악성 전이 가능성 역시 거의 없다.

• Korean Journal of Radiology
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• 제22권5호
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• pp.751-758
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• 2021

Objective: Preoperative differentiation between inverted papilloma (IP) and its malignant transformation to squamous cell carcinoma (IP-SCC) is critical for patient management. We aimed to determine the diagnostic accuracy of conventional imaging features and histogram parameters obtained from whole tumor apparent diffusion coefficient (ADC) values to predict IP-SCC in patients with IP, using decision tree analysis. Materials and Methods: In this retrospective study, we analyzed data generated from the records of 180 consecutive patients with histopathologically diagnosed IP or IP-SCC who underwent head and neck magnetic resonance imaging, including diffusion-weighted imaging and 62 patients were included in the study. To obtain whole tumor ADC values, the region of interest was placed to cover the entire volume of the tumor. Classification and regression tree analyses were performed to determine the most significant predictors of IP-SCC among multiple covariates. The final tree was selected by cross-validation pruning based on minimal error. Results: Of 62 patients with IP, 21 (34%) had IP-SCC. The decision tree analysis revealed that the loss of convoluted cerebriform pattern and the 20th percentile cutoff of ADC were the most significant predictors of IP-SCC. With these decision trees, the sensitivity, specificity, accuracy, and C-statistics were 86% (18 out of 21; 95% confidence interval [CI], 65-95%), 100% (41 out of 41; 95% CI, 91-100%), 95% (59 out of 61; 95% CI, 87-98%), and 0.966 (95% CI, 0.912-1.000), respectively. Conclusion: Decision tree analysis using conventional imaging features and histogram analysis of whole volume ADC could predict IP-SCC in patients with IP with high diagnostic accuracy.

• Asian Pacific Journal of Cancer Prevention
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• 제16권10호
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• pp.4265-4269
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• 2015

Introduction: The aim of the study was to explore the distribution of eyelid tumors in Ankara, the capital city of Turkey, from a histopathological point of view. Materials and Methods: Medical records of 1,502 patients who had eyelid surgery because of tumoral lesions were retrospectively reviewed after obtaining institutional review board approval. A total of 1,541 lesions with histopathologic diagnosis were included. Inflammatory tumoral lesions were excluded. The lesions were categorized into three groups according to the origin: epidermal, adnexal tumors and 'others', including melanocytic, neural and vascular lesions. Results: Of the total of 1,541, 908 lesions were epidermal in origin. Only 22 (1.5%) were malignant, and 6.0% was premalignant lesions such as actinic keratosis and Bowen's disease. Twenty-one of 22 malignant lesions were basal cell carcinoma. There was only one patient with squamous cell carcinoma and no sebaceous cell carcinoma. Among the benign tumors (92.5%), squamous papilloma was the most frequent (21.8% of all lesions). The other frequent lesions were nevus (17.6%), seborrheic keratosis (17.3%), hydrocystomas (10.6%), xanthelasma (7.6%) and epidermal cysts (7.2%). Conclusions: The results of this study are in accordance with published literature. The absence of sebaceous cell carcinomas needs to be stressed.

• The Journal of Advanced Prosthodontics
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• 제6권6호
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• pp.555-558
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• 2014

Focal epithelial hyperplasia (FEH) is a human papillomavirus (HPV)-induced alteration of the oral mucosa that presents with a clinically distinct appearance. While other HPV-infected lesions such as squamous papilloma, verruca vulgaris, and condyloma acuminatum involve the skin, oral mucosa, and genital mucosa, FEH occurs only in the oral mucosa. The affected oral mucosa exhibits multiple papules and nodules with each papule/nodule being flat-topped or sessile. The affected region resembles the normal color of oral mucosa rather than appearing as a white color since the epithelial surface is not hyperkeratinized. Almost all cases present with multiple sites of occurrence. This rare, benign epithelial proliferation is related to low-risk HPV, especially HPV-13 and -32, and is not transformed into carcinoma. We report a case of FEH that arose on the attached gingiva of an East Asian male adult related to prosthesis without detection of any HPV subtype in HPV DNA chip and sequencing.

• 치위생과학회지
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• 제13권3호
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• pp.354-357
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• 2013

심상성 사마귀는 피부에서 매우 흔하게 관찰되는 병소중하나이다. 보통 심상성 사마귀는 인간 유두종 바이러스 중저위험군에 의해서 발생된다. 심상성 사마귀는 구강 점막에서 거의 나타나지 않지만 편평유두종으로 오진될 수 있다. 그러므로 저자들은 구강에서 발생한 심상성 사마귀 8예를 임상 병리학적 특징을 관찰하여 보고하였다.

• 대한한방부인과학회지
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• 제21권4호
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• pp.237-246
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• 2008

Purpose: Recently people who want to treatment of cervical dysplasia by Traditional Korean Medicine (TKM) were increased. The purpose of these studies are to confirm the clinical effectiveness of TKM treatment to clinical symptoms of the patients who diagnosed as cervical dysplasia. Methods: The patients who diagnosed as cervical dysplasia, had elytrorrhagia, leukorrhea, dysmenorrhea et al. The patients were treated by TKM such as herb medication and acupuncture therapy. Results: After the oriental medical treatment. the clinical symptoms such as elytrorrhagia, leukorrhea, dysmenorrhea were improved. Conclusion: To treatment and management of cervical dysplasia, we were based on improvement of clinical symptoms. And we used TKM to the clinical symptoms of patients with cervical dysplasia, in result clinical symptoms of cervical dysplasia were improved. TKM is expected to have positive effects on clinical symptoms of cervical dysplasia.

• Archives of Plastic Surgery
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• 제50권1호
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• pp.59-62
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• 2023

A 57-year-old man presented with a pigmented papule, 0.4 cm in diameter, on the left lower eyelid. Skin biopsy revealed a basal cell carcinoma, which was excised through a wide excision followed by a full-thickness skin graft (FTSG). Two weeks after the surgery, an erythematous nodule developed in the lower margin of the graft recipient site. The nodule size increased rapidly over 2 weeks, becoming dome-shaped with a central hyperkeratotic plug. A diagnosis of keratoacanthoma (KA) was made, and surgical excision was performed. Histological findings revealed a large, well-differentiated squamous tumor with a central keratin-filled crater and buttress. The human papilloma virus (HPV) genotyping results were negative. Risk factors for KA include trauma, old age, exposure to ultraviolet (UV) radiation, immunosuppression, and HPV infection. KA has most often been reported to develop at the donor site. Although the pathogenesis of KA is unclear, trauma is believed to act as a second insult to a preceding oncogenic insult, such as exposure to UV radiation, resulting in a koebnerization. Herein, we report a case of solitary KA at a FTSG recipient site. This report presents information that may provide guidance during dermatologic surgeries.

• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4491-4501
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• 2016

Verruco-papillary lesions (VPLs) of the oral cavity described in the literature involve a spectrum of conditions including squamous papilloma, verruca vulgaris, focal epithelial hyperplasia, condyloma, proliferative verrucous leukoplakia and verrucous carcinoma. A majority of the VPLs are slow growing, benign in nature and have a viral aetiology. Virus associated benign mucosal outgrowths are not too difficult to diagnose either clinically or by microscopy. Apart from virus-associated lesions, VPLs harboring malignant potential or behaviour such as verrucous carcinoma, proliferative verrucous leukoplakia, oral verrucous hyperplasia (OVH), oral papillary squamous cell carcinoma (PSCC) and oral conventional squamous cell carcinoma with papillary features (CSCC) need to be further clarified for better understanding of their predictable biologic behavior and appropriate treatment. Current understanding of potentially malignant VPLs is perplexing and is primarily attributed to the use of confusing and unsatisfactory terminology. In particular, the condition referred to as oral verrucous hyperplasia (OVH) poses a major diagnostic challenge. OVH represents a histopathological entity whose clinical features are not well recognised and is usually clinically indistinguishable from a verrucous carcinoma and a PSCC or a CSCC. A consensus report published by an expert working group from South Asia as an outcome of the 'First Asian Regional Meeting on the Terminology and Criteria for Verruco-papillary Lesions of the Oral Cavity' held in Kuala Lumpur, Malaysia, recognised the clinical description of these OVH as a new entity named 'Exophytic Verrucous Hyperplasia'. Previously described clinical features of OVH such as the 'blunt' or 'sharp' variants; and the 'mass' or 'plaque' variants can now collectively fall under this newly described entity. This paper discusses in detail the application of the standardized criteria guidelines of 'Exophytic Verrucous Hyperplasia' as published by the expert group which will enable clinicians and pathologists to uniformly interpret their pool of OVH cases and facilitate a better understanding of OVH malignant potential.

• 생명과학회지
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• 제21권3호
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• pp.417-423
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• 2011

사이모신 베타 4와 관련 단백질인 HIF-$1{\alpha}$ 및 VEGF의 발현을 여러 인간 암 조직에서 tissue microarray를 사용하여 조사하였다. 사이모신 베타 4는 골육중, 대장 선암, 식도 편평세포암, 신장 및 방광의 이행세포암, 폐암 및 간암에서 많이 발현되었으며 HIF-$1{\alpha}$은 비강 역위성 유두종, 폐암 및 식도 편평세포암에서 강한 발현을 보였으며 대체로 발현되는 양상이나 위치가 사이모신 베타 4와 일치하는 것으로 관찰되었다. VEGF는 암 조직에서보다 암조직에 분포된 혈관내피에서 강하게 발현되는 양상을 나타내었으며 암세포에서는 사이모신 베타 4나 HIF-$1{\alpha}$에 비해 강하게 발현되지 않았다. 위암, 간 혈관육종, 담낭 선암과 자궁 내막 선암에서 적당 수준의 VEGF 발현이 관찰되었으며 VEGF의 발현 양상 및 위치는 위암, 골육종, 지방종, 폐암, 간암, 담낭 선암, 식도 편평세포암, 대장 및 직장암, 신세포암을 포함하는 특정 암에서 사이모신 베타 4 및 HIF-$1{\alpha}$와 일치하는 것으로 관찰되었다.

• Asian Pacific Journal of Cancer Prevention
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• 제15권19호
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• pp.8351-8359
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• 2014

Background: Recent epidemiological data have implicated human papilloma virus (HPV) infection in the pathogenesis of head and neck cancers, especially oropharyngeal cancers. Although, HPV has been detected in varied amounts in persons with oral dysplasia, leukoplakias and malignancies, its involvement in oral tongue carcinogenesis remains ambiguous. Materials and Methods: HPV DNA prevalence was assessed by PCR with formalin fixed paraffin embedded sections (n=167) of oral tongue squamous cell carcinoma patients and the physical status of the HPV16 DNA was assessed by qPCR. Immunohistochemistry was conducted for p16 evaluation. Results: We found the HPV prevalence in tongue cancers to be 51.2%, HPV 16 being present in 85.2% of the positive cases. A notable finding was a very poor concordance between HPV 16 DNA and p16 IHC findings (kappa<0.2). Further molecular classification of patients based on HPV16 DNA prevalence and p16 overexpression showed that patients with tumours showing p16 overexpression had increased hazard of death (HR=2.395; p=0.005) and disease recurrence (HR=2.581; p=0.002) irrespective of their HPV 16 DNA status. Conclusions: Our study has brought out several key facets which can potentially redefine our understanding of tongue cancer tumorigenesis. It has emphatically shown p16 overexpression to be a single important prognostic variable in defining a high risk group and depicting a poorer prognosis, thus highlighting the need for its routine assessment in tongue cancers. Another significant finding was a very poor concordance between p16 expression and HPV infection suggesting that p16 expression should possibly not be used as a surrogate marker for HPV infection in tongue cancers. Interestingly, the prognostic significance of p16 overexpression is different from that reported in oropharyngeal cancers. The mechanism of HPV independent p16 over expression in oral tongue cancers is possibly a distinct entity and needs to be further studied.