Oral verruciform xanthoma associated with chronic graft-versus-host disease: a report of five cases and a review of the literature

Abstract

Verruciform xanthoma (VX) is an uncommon benign inflammatory mucocutaneous condition that chiefly occurs in the oral cavity. It is often associated with pre-existing epithelial and/or inflammatory disorder and is characterized histopathologically by papillary epithelial hyperplasia and the presence of foamy macrophages in connective tissue papillae. We report of a series of five cases with VX who concurrently had chronic oral graft-versus-host disease following hematopoietic stem cell transplantation.

Fig. 1

Case 1 showing a well-demarcated papillary reddish plaque of the left buccal mucosa

Fig. 2

Case 2 showing a pedunculated papillary nodule on the right posterior tongue dorsum

Fig. 3

Case 3 showing a well-demarcated yellowish verrucous plaque on the left lateral ventral tongue

Fig. 4

Case 4 showing a well-demarcated erythematous papillary plaque on the maxillary labial mucosa

Fig. 5

Case 5 showing a well-defined reddish granular plaque (solid arrow) and a separate unrelated area of leukoplakia (dotted arrow) on the right hard palate

Fig. 6

a Photomicrograph of a verruciform xanthoma (case 4) with papillary epithelial hyperplasia, hyperkeratosis, parakeratin plugging, and uniformly elongated rete ridges, (H&E, × 40). b Photomicrograph (case 4) showing numerous large, vacuolated foam cells that fill the connective tissue papillae with overlying parakeratosis (H&E, × 200)