Department of Pathology, VCU School of Medicine, Richmond, VA, USA.
Department of Dermatology, VCU School of Medicine, Richmond, VA, USA.
Histopathology. 2020 Nov;77(5):841-846. doi: 10.1111/his.14198. Epub 2020 Sep 15.
Verruciform xanthoma (VX) is an uncommon lesion, seen in the oral mucosa and rarely occurring at cutaneous genital sites. Reports of exceptional VX presentations dominate the literature; herein, we assess the clinical and histological features of a cohort of routine, consecutive cases.
Clinicopathological features of genital VXs from four academic centres were reviewed. A cohort of 25 lesions from 24 patients (22 male, two female; median age = 62 years), occurred on the scrotum (84%), penis (8%) and perineum/vulva (8%). VX was never suspected clinically; considerations ranged from fibroepithelial polyps to squamous cell carcinoma. Classic diagnostic criteria were present at least focally in each lesion, including verrucous architecture, prominent wedge-shaped parakeratosis extending between exophytic epidermal projections and neutrophils in the stratum corneum. Xanthomatous cells were present in all cases, but scattered to rare in 24%.
Consecutive genital VXs reliably exhibited classic histopathological features, although the essential finding of xanthomatous cells may be scarce. Our comparison to meta-analyses of published cases found relatively fewer penile and vulvar examples. Additionally, the median age was older than in published series, which have emphasised syndromic associations.
疣状黄瘤（VX）是一种罕见的病变，见于口腔黏膜，很少发生在皮肤生殖器部位。文献中主要报道了罕见的 VX 表现；在此，我们评估了来自四个学术中心的一组常规连续病例的临床和组织学特征。
回顾了来自四个学术中心的生殖器 VX 的临床病理特征。该队列包括 24 名患者（22 名男性，2 名女性；中位年龄 62 岁）的 25 个病变，发生在阴囊（84%）、阴茎（8%）和会阴/外阴（8%）。临床上从未怀疑过 VX；考虑的范围从纤维上皮性息肉到鳞状细胞癌。每个病变至少有局灶性存在经典的诊断标准，包括疣状结构、突出的楔形角化不全，延伸到外生表皮突起之间和角质层中的中性粒细胞。所有病例均存在黄瘤细胞，但仅 24%的病例存在散在或罕见的黄瘤细胞。
连续的生殖器 VX 可靠地表现出经典的组织病理学特征，尽管必需的黄瘤细胞发现可能很少。与已发表病例的荟萃分析相比，我们发现阴茎和外阴的病例相对较少。此外，中位年龄大于已发表的强调综合征相关性的系列研究。
