Abstract
Oral verruciform xanthoma (OVX) is an uncommon benign lesion that is characterized histologically by the accumulation of several foamy macrophages in the lamina propria papillae. The pathogenesis of OVX has not been completely elucidated, although the significance of macrophage polarization (M1, tumor suppression; and M2, tumor promotion) and the contribution of M2 macrophages to angiogenesis are well established. This study investigated the role of foamy macrophages in OVX, with a focus on angiogenesis. Four patients who underwent surgical excision or total excisional biopsy for OVXs were enrolled in this study. We evaluated the expression of the macrophage markers CD68 (broad) and CD163 (M2) and the CD34-positive microvessel density (MVD) of OVXs. The foamy macrophages of all patients exhibited positivity to CD68 and CD163. We evaluated the MVD and the expression of the vascular endothelial growth factor (VEGF) based on histological architecture. The MVD of all OVX cases was significantly higher than that of the corresponding normal epithelia. Interestingly, the MVD of verrucous-type OVX cases was higher than that of the other type. VEGF was expressed on foamy macrophages in all cases. Overall, the foamy macrophages expressing CD163 were associated with the morphogenesis of OVX through the process of angiogenesis by VEGF expression.
Highlights
Oral verruciform xanthoma (OVX) is a rare benign lesion that was first reported in 1971 [1].Microscopically, OVX is characterized by papillary or verrucous proliferation of squamous epithelium with keratosis and several foamy macrophages accumulated in the lamina propria papillae.The pathogenesis of OVX remains unclear
It has been suggested that the verrucous and papillary epithelial architecture of OVX is secondary to the presence of foamy macrophages, which affects the metabolism of the epithelial cells, thereby leading to keratotic changes [6]
We have recently reported about the significance of CD163+ macrophages in oral carcinogenesis [13,14]
Summary
Oral verruciform xanthoma (OVX) is a rare benign lesion that was first reported in 1971 [1].Microscopically, OVX is characterized by papillary or verrucous proliferation of squamous epithelium with keratosis and several foamy macrophages accumulated in the lamina propria papillae.The pathogenesis of OVX remains unclear. Oral verruciform xanthoma (OVX) is a rare benign lesion that was first reported in 1971 [1]. OVX is characterized by papillary or verrucous proliferation of squamous epithelium with keratosis and several foamy macrophages accumulated in the lamina propria papillae. Several researchers have reported that OVX is a reactive lesion with lipid-containing macrophages resulting from epithelial cell degeneration [2,3,4,5]. It has been suggested that the verrucous and papillary epithelial architecture of OVX is secondary to the presence of foamy macrophages, which affects the metabolism of the epithelial cells, thereby leading to keratotic changes [6]. Macrophages are divided into M1 (tumor suppression) and
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