Elastofibromatous changes and hyperelastosis of the oral mucosa

Abstract

Three cases of abnormalities of elastic fibers, two of them on the floor of the mouth and one on the lingual alveolar mucosa, close to the floor of the mouth, in a patient with history of homolateral squamous cell carcinoma of the floor of the mouth, are presented. Comparison with elastofibromatous changes and elastofibromas are made and their possible pathogenesis is discussed. It is suggested that increased awareness may facilitate recognition of such lesions as they can be easily overlooked, especially when they do not present as discrete tumors or they are associated with other "more significant" pathologic processes.

Fig. 1

a Mucosal fragment surfaced by hyperkeratinizing stratified squamous epithelium with a well defined, eosinophilic to amphophilic, and hypocellular area (arrows) in the connective tissue (H and E, original magnification ×40). b Irregular fibriliar and globular deposits (H and E, original magnification ×200). c Thickened, wavy, and fragmented elastic fibers (Vierhoeff-van Gieson elastic stain, original magnification ×200)

Fig. 2

a Mucosal fragment surfaced by hyperkeratinizing stratified squamous epithelium with hypocellular area (arrows) in the connective tissue exhibiting dense collagen and ampophilic deposits consistent with elastic fibers. (H and E, original magnification ×20). b Amphophilic deposits consistent with elastic fibers (H and E, original magnification ×200). c Hyperplastic wavy, fragmented and globe-shaped elastic fibers intermingled with dense collagen (Vierhoeff-van Gieson elastic stain, original magnification ×200)

Fig. 3

a Mucosal fragment covered by partially hyperparakeratinized and acanthotic stratified squamous epithelium with increased vascularity and amphophilic/eosinophilic deposits (arrows) in the connective tissue (H and E, original magnification ×80). b Amphophilic changes consistent with hyperplastic elastic tissue (H and E, original magnification ×200). c Hyperplastic wavy and fragmented elastic fibers (Vierhoeff-van Gieson elastic stain, original magnification ×400)