Esophagus
Benign tumors
Squamous papilloma


Topic Completed: 22 June 2020

Minor changes: 22 June 2020

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PubMed Search: Squamous papilloma[TIAB] esophagus

Yukihiro Nakanishi M.D., Ph.D.
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Cite this page: Nakanishi Y. Squamous papilloma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/esophagussquamouspapilloma.html. Accessed July 2nd, 2020.
Definition / general
  • Benign esophageal epithelial polyp composed of squamous epithelium with a papillary growth pattern
Essential features
  • Papillary proliferation of nondysplastic squamous epithelium with fibrovascular cores of lamina propria
  • Etiologic factors include irritation (alcohol consumption, smoking and reflux esophagitis, metal stent and chronic food impaction), infection (HPV infection) and genetic syndromes (Goltz-Gorlin syndrome and angioma serpiginosum)
  • Human papilloma virus infection rate: 10.5 - 57%
  • Often seen in the distal esophagus in the U.S. (58.3 - 70%) and the middle esophagus in Asian countries (52.6 [Japan] - 57.5% [Taiwan])
Terminology
  • Squamous cell papilloma
ICD coding
  • ICD-O: 8052/0 - squamous cell papilloma, NOS
Sites
Pathophysiology
  • Chronic mucosal irritation or HPV infection followed by hyperregenerative response / proliferation of squamous epithelium
Etiology
Clinical features
Diagnosis
  • Incidentally found on endoscopy
  • Confirmed on biopsy
Prognostic factors
  • No known prognostic factors (progression to dysplasia or carcinoma is extremely rare)
Case reports
Treatment
Clinical images

Images hosted on other servers:

Squamous papilloma with warty surface

Squamous papillomatosis

Gross description
  • Small (usually < 5 mm), sessile, whitish, warty polypoid lesion
Microscopic (histologic) description
  • Papillary proliferation of nondysplastic squamous epithelium with fibrovascular cores of lamina propria
  • Koilocytes can be seen
  • Most commonly, exophytic but rarely, endophytic and tentacular type proliferation (Mayo Clin Proc 2019;94:1551)
  • No dysplasia is seen (progression to dysplasia or carcinoma is extremely rare)
Microscopic (histologic) images

Contributed by Yukihiro Nakanishi M.D., Ph.D.

Esophageal polypoid lesion

Sample pathology report
  • Esophagus, mid, polyp, biopsy:
    • Squamous papilloma (see comment)
    • Comment: It is negative for dysplasia or carcinoma.
Differential diagnosis
Board review style question #1

Which of the following is true about the lesion shown in this picture?

  1. Koilocytes can be seen
  2. Patients need aggressive treatment including chemotherapy and radiation
  3. Patients present with dysphagia
  4. Prominent granular layer is one of the characteristic findings
Board review answer #1
A. Koilocytes can be seen in squamous papilloma of the esophagus.

Comment Here

Reference: Esophagus - squamous papilloma
Board review style question #2
Which of the following is true about squamous papilloma of the esophagus?

  1. Almost all squamous papillomas of the esophagus are associated with human papilloma virus infection
  2. Gastroesophageal reflux disease is one of the etiologic factors
  3. Most patients are young women with human papilloma virus infection
  4. Usually it is seen in the cervical esophagus
Board review answer #2
B. Gastroesophageal reflux disease is one of the etiologic factors.

Comment Here

Reference: Esophagus - squamous papilloma
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