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Pale (Clear) Cell Acanthoma of the Palate.
Head Neck Pathol. 2020 Jun; 14(2):535-541.HN

Abstract

Clear cell acanthoma (CCA), also known as pale cell acanthoma, represents a rare benign epidermal tumor with strong predilection for the lower extremities of middle-aged individuals and no frank gender preference. The etiology of CCA is poorly understood, although a localized psoriasiform reaction is favored. Herein, we report on the clinicopathologic and immunohistochemical features, and HPV status of an apparent example of oral CCA. A 58-year-old female presented with a well-circumscribed, asymptomatic, exophytic, sessile and erythematous nodule of the right hard palate, measuring 0.7 cm in greatest dimension. Microscopically, the lesion featured parakeratosis and acanthosis with neutrophilic microabscesses and broad elongated rete pegs. In areas, spinous epithelial cells exhibited pale or clear cytoplasm without nuclear pleomorphism, mitoses or cytologic atypia. The supporting connective tissue revealed mild chronic inflammation with few scattered neutrophils and numerous capillary vessels. PAS histochemical stain with and without diastase disclosed the presence of cytoplasmic glycogen in the pale cells. The majority of glycogen-rich epithelial cells stained strongly for EMA and were negative for D2-40. Ki-67 immunostaining was confined only to the basal cell layer of the epithelium. A diagnosis of CCA was rendered. The lesion was negative for human papillomavirus (HPV) infection, as assessed by HPV-DNA PCR using the MY09/11 primers for the L1 conserved region, thus HPV infection does not appear to contribute to the pathogenesis of oral CCA. In conclusion, we report an intraoral example of CCA in order to raise awareness about this entity.

Authors+Show Affiliations

Department of Biochemistry, Molecular Biology, and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN, USA. argyr005@umn.edu. Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN, 55455, USA. argyr005@umn.edu.Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN, 55455, USA.Department of Laboratory Medicine and Pathology, School of Medicine, University of Minnesota, Minneapolis, MN, USA.Division of Oral and Maxillofacial Pathology, Department of Diagnostic and Biological Sciences, School of Dentistry, University of Minnesota, 515 Delaware Street SE 16-206B, Minneapolis, MN, 55455, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31230231

Citation

Argyris, Prokopios P., et al. "Pale (Clear) Cell Acanthoma of the Palate." Head and Neck Pathology, vol. 14, no. 2, 2020, pp. 535-541.
Argyris PP, Ho D, Nelson AC, et al. Pale (Clear) Cell Acanthoma of the Palate. Head Neck Pathol. 2020;14(2):535-541.
Argyris, P. P., Ho, D., Nelson, A. C., & Koutlas, I. G. (2020). Pale (Clear) Cell Acanthoma of the Palate. Head and Neck Pathology, 14(2), 535-541. https://doi.org/10.1007/s12105-019-01050-0
Argyris PP, et al. Pale (Clear) Cell Acanthoma of the Palate. Head Neck Pathol. 2020;14(2):535-541. PubMed PMID: 31230231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pale (Clear) Cell Acanthoma of the Palate. AU - Argyris,Prokopios P, AU - Ho,Dan, AU - Nelson,Andrew C, AU - Koutlas,Ioannis G, Y1 - 2019/06/22/ PY - 2019/04/23/received PY - 2019/06/18/accepted PY - 2019/6/24/pubmed PY - 2019/6/24/medline PY - 2019/6/24/entrez KW - Clear cell acanthoma KW - Clear cell acanthosis KW - EMA KW - Glycogen-rich acanthoma KW - HPV–PCR KW - Oral cavity KW - Pale cell acanthoma SP - 535 EP - 541 JF - Head and neck pathology JO - Head Neck Pathol VL - 14 IS - 2 N2 - Clear cell acanthoma (CCA), also known as pale cell acanthoma, represents a rare benign epidermal tumor with strong predilection for the lower extremities of middle-aged individuals and no frank gender preference. The etiology of CCA is poorly understood, although a localized psoriasiform reaction is favored. Herein, we report on the clinicopathologic and immunohistochemical features, and HPV status of an apparent example of oral CCA. A 58-year-old female presented with a well-circumscribed, asymptomatic, exophytic, sessile and erythematous nodule of the right hard palate, measuring 0.7 cm in greatest dimension. Microscopically, the lesion featured parakeratosis and acanthosis with neutrophilic microabscesses and broad elongated rete pegs. In areas, spinous epithelial cells exhibited pale or clear cytoplasm without nuclear pleomorphism, mitoses or cytologic atypia. The supporting connective tissue revealed mild chronic inflammation with few scattered neutrophils and numerous capillary vessels. PAS histochemical stain with and without diastase disclosed the presence of cytoplasmic glycogen in the pale cells. The majority of glycogen-rich epithelial cells stained strongly for EMA and were negative for D2-40. Ki-67 immunostaining was confined only to the basal cell layer of the epithelium. A diagnosis of CCA was rendered. The lesion was negative for human papillomavirus (HPV) infection, as assessed by HPV-DNA PCR using the MY09/11 primers for the L1 conserved region, thus HPV infection does not appear to contribute to the pathogenesis of oral CCA. In conclusion, we report an intraoral example of CCA in order to raise awareness about this entity. SN - 1936-0568 UR - https://www.unboundmedicine.com/medline/citation/31230231/Pale_(Clear)_Cell_Acanthoma_of_the_Palate L2 - https://dx.doi.org/10.1007/s12105-019-01050-0 DB - PRIME DP - Unbound Medicine ER -
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